Elsevier

The Journal of Arthroplasty

Volume 16, Issue 6, September 2001, Pages 679-688
The Journal of Arthroplasty

Original Articles
Venous thromboembolic disease management patterns in total hip arthroplasty and total knee arthroplasty patients: A survey of the AAHKS membership,☆☆

https://doi.org/10.1054/arth.2001.25506Get rights and content

Abstract

The American Association of Hip and Knee Surgeons (AAHKS) distributed a survey to its members exploring practice patterns implemented to prevent venous thromboembolic disease (VTED) in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Of 720 (33%) members, 236 responded. Prophylaxis was prescribed for 100% of patients during the course of hospitalization for THA and TKA. Warfarin was the commonest pharmacologic treatment used for THA (66%) and TKA (59%) patients. Low-molecular-weight heparin was used in 16% of THA patients and 18% of TKA patients. The most commonly employed mechanical modality was pneumatic devices in THA (51%) and TKA (50%). Universal acceptance of the need for prophylaxis administration for patients undergoing THA and TKA is shown. The method and duration remain highly variable; although the survey illustrates such variation, it suggests there is no one best method of prophylaxis.

Section snippets

Methods

A unique group of orthopaedic surgeons, who performed a minimum of 50 THA and TKA operations per year and were members of the American Association of Hip and Knee Surgeons (AAHKS), were mailed a 15-question survey developed by the AAHKS Research Committee. The American Academy of Orthopaedic Surgeons (AAOS) research department assisted in the survey design to facilitate scanning and data tabulation (see Appendix). The major elements of the questionnaire related to current choices and duration

Surgeon demographics

The surgeon's practice setting was an orthopaedic group in 78% (183 of 236), a multispecialty group in 14% (32 of 236), and solo practice in 9% (21 of 236). Of respondents, 76% (180 of 236) were in a private practice environment, whereas 19% (46 of 236) were in an academic environment. Two percent (5 of 236) were employees of a hospital, 2% (4 of 236) were employees of a health maintenance organization or prepaid plan, and 0.4% (1 of 236) were employees of the U.S. government in the armed

Discussion

Many surveys of surgeon practices regarding VTED prophylaxis have been published 1, 2, 3, 4, 5. The general surgical literature suggests an increased use of prophylactic agents in more recent years compared with earlier times in commonly performed procedures among surgeons who responded to the surveys. In 1982, Conti and Daschehbach [3] sent 994 general surgeons a survey that included 10 hypothetical clinical situations illustrating variable risks of deep venous thrombosis and asked for the

Acknowledgements

We thank the members of the AAHKS who completed and returned this survey, making this report possible. We also thank Wanda Swenson for her editorial assistance.

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    No benefits or funds were received in support of this study.

    ☆☆

    Reprint requests: J. Wesley Mesko, MD, Michigan Orthopedic Center, 2901 Stabler Street, Lansing, MI 48910. E-mail: [email protected]

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