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Thromboembolism after hip and knee arthroplasty: diagnosis and treatment

Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York, NY, USA.

Postoperative thromboembolism is a potentially lethal complication. Its diagnosis may be difficult, as the classic clinical signs and symptoms are often absent, making a high index of suspicion imperative for diagnosis. Anticoagulant therapy is effective in reducing morbidity and mortality due to thromboembolism, but is associated with a substantial rate of bleeding complications in the immediate postoperative period. Inferior vena cava filters constitute an alternative to anticoagulant therapy, but are also associated with a substantial complication rate. The appropriate use of diagnostic tests combined with clinical suspicion can guide the orthopaedic surgeon in deciding which patients require treatment for thromboembolism.