Evaluation of deep venous thrombosis prophylaxis in low-risk patients undergoing total knee arthroplasty.

Callaghan, John J; Warth, Lucian C; Hoballah, Jamal J; Liu, Steve S; Wells, Christopher W

Our objective of the study was to address the question: "What is the efficacy of a deep venous thrombosis (DVT) and pulmonary embolus prophylaxis protocol after total knee arthroplasty (TKA) in which low-risk patients had only aspirin and mechanical devices for prophylaxis?" A multimodal approach to DVT prophylaxis using aspirin as the primary mode of chemoprophylaxis was successful in preventing DVT-related morbidity and mortality in 312 consecutive TKAs performed in low-risk patients. There were no DVT-related deaths and no deaths in general at 90 days of follow-up coupled with a low rate of readmission for thromboembolic events and no readmissions or reoperations from bleeding in this group. This low-morbidity, low-cost prophylaxis should be considered an appropriate protocol for low-risk patients undergoing TKA. Of all TKAs performed during the time period of the study, 73% qualified for the low-risk group.