PT  - JOURNAL ARTICLE
AU  - Gross, Michael
AU  - Anderson, David R.
AU  - Nagpal, Seema
AU  - O’Brien, Bernie
TI  - Venous thromboembolism prophylaxis after total hip or knee arthroplasty: a survey of Canadian orthopedic surgeons
DP  - 1999 Dec 01
TA  - Canadian Journal of Surgery
PG  - 457--461
VI  - 42
IP  - 6
4099  - http://canjsurg.ca/content/42/6/457.short
4100  - http://canjsurg.ca/content/42/6/457.full
SO  - CAN J SURG1999 Dec 01; 42
AB  - Objective: To determine the pharmacologic and physical modalities used by orthopedic surgeons in Canada to prevent venous thromboembolism (deep venous thrombosis and pulmonary embolism) after total hip or knee arthroplasty.Design: Mail survey sent to all members of the Canadian Orthopaedic Association.Setting: A nation-wide study.Methods: A total of 828 questionnaires, designed to identify the type and frequency of prophylaxis against venous thromboembolism that were used after hip and knee arthroplasty were mailed to orthopedic surgeons.Outcome measures: Demographic data and the frequency and type of thromboprophylaxis.Results: Of the 828 surveys mailed 445 (54%) were returned, and 397 were included in this analysis. Of the respondents, 97% used prophylaxis routinely for patients who undergo total hip or knee arthroplasty. Three of the 397 (0.8%) did not use any method of prophylaxis. Warfarin was the most common agent used (46%), followed by low-molecular-weight heparin (LMWH) (36%). Combination therapy with both mechanical and pharmacologic methods were used in 39% of patients. Objective screening tests were not frequently performed before discharge. Extended prophylaxis beyond the duration of hospitalization was used by 36% of physicians.Conclusion: Prophylaxis for venous thromboembolism with warfarin or LMWH has become standard care after total hip or knee arthroplasty in Canada.