Thromboprophylaxis in elderly patients undergoing major orthopaedic surgery.

The overall aging of our population and the success of total joint arthroplasty has rapidly increased the number of these surgeries performed. With total joint arthroplasty of the lower extremity, the risk of development of venous thrombosis is significant. As people age, co-morbidities and the risk of thrombosis also increase. A range of prophylactic strategies that can dramatically reduce the prevalence of venous thromboembolism in the aging population are available. Thromboprophylaxis has been shown in many randomized trials to reduce the incidence of venous thromboembolism in patients undergoing total joint arthroplasty. Use of any prophylaxis has to be examined in terms of risks and benefits to the patient. Generalized use of the guidelines published in Chest has substantially reduced the incidence of venous thromboembolism in the hospitalized elderly patient undergoing major orthopaedic surgery of the lower extremity. Adhering to published evidence-based guidelines can greatly decrease the number of thromboembolic events seen in elderly patients undergoing major orthopaedic surgery.