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1、TheJournalofArthroplastyVol.23No.7Suppl.12008DeepVenousThrombosisProphylaxisforTotalJointArthroplasty:AmericanAcademyofOrthopaedicSurgeonsGuidelinesJavadParvizi,MD,FRCS,KhalidAzzam,MD,andRichardH.Rothman,MD,PhDAbstract:Theorthopediccommunitycontinuestofaceachalleng
2、ewithregardtothepreventionofthromboembolismaftertotaljointarthroplasty.Thefirstandforemostissuefacingsurgeonsishowtoselectthebestagentormodalitythatiseffectiveinpreventingtheuntowardconsequencesofthromboembolismwithoutcausingothercomplicationsthatcanhavedireconsequ
3、ences.Otherchallengesincludetheuncertaintyregardingthedoseanddurationofvariousagents,thevalueofmechanicalprophylaxisalone,andtheexactendpointsthatshouldbeusedtomeasuretheefficacyofprophylaxis.Thisarticlediscussessomeoftherecentdevelopmentsinpreventionandmanagemento
4、fthromboembolismaftertotaljointarthroplasty,inparticularhighlightingtheguidelinesthatweredevelopedbyAmericanAcademyofOrthopedicSurgeons.Keywords:totaljointarthroplasty,thromboembolism,prophylaxis,AAOSguidelines.©2008ElsevierInc.Allrightsreserved.Thedebateastowhatco
5、nstitutesthemosteffectivebiticsyndrome,andpulmonaryembolism(PE),astrategytopreventvenousthromboembolismmodalitythatdoesallthesethingsprobablydoes(VTE)aftertotaljointarthroplastycontinues.notexist;andattemptstodosomayresultinDespiteallefforts,itisunlikelythata“singl
6、e”unintendedcomplications.strategycanbedeveloped.ThereisamultitudeofAfewyearsago,theAmericanCollegeofChestreasonsforfailingtofindthemosteffectiveagentPhysicians(ACCP),intheirattempttoassisttheormodality,mostimportantlythoserelatedtotheorthopediccommunityinpreventin
7、gvenousuncertaintyaboutwhichparticularthromboem-thromboemboliceventsafterjointarthroplasty,boliceventtheorthopediccommunityisattemptingissuedguidelines[1].Theseguidelinesweredevel-toprevent.Althoughitismostdesirabletopreventopedbasedonevaluationoftheavailablelitera
8、tureeverythromboemboliceventsuchasdistalandusingpreventionofdistalDVTastheendpointinproximaldeepvenousthrombosis(DVT),postphle-determiningtheeffi
