Medidas de Tromboprofilaxis en Artroplastia Total de Rodilla. Práctica habitual en la Comunidad Valenciana y revisión bibliográfica

Thromboembolism is one of the Total Knee Arthroplasty risks. For its prevention we have multiple physical and pharmacological measures availables. Objective: To know which thromboembolic prevention measures are those used by orthopedic surgeons in knee replacement surgery in different hospital centers in our region. Method: Observational descriptive cross-sectional study based on a survey directed at orthopedic surgeons from 9 public hospitals in the Valencian Community and a bibliographic search. Results: 64 completed surveys were obtained. All surgeons choose LMWH for one month as a thromboprophylaxis measure, ruling out oral anticoagulants or aspirin. 29% also employ passive motion devices. Conclusions: Orthopedic surgeons from the Valencian Community opt for LMWH guided by the best evidence. It is estimated that the incidence of symptomatic thromboembolic events drops from 4.3% to 1.8% with the use of LMWH. The use of passive motion devices and graduated compression stockings are not supported by the evidence. The preoperative stratification of the risk of thromboembolism, to use aspirin associated with intermittent pneumatic compression device in the absence of high risk, is an increasingly internationally accepted trend.