Perioperative Management of Chronic Anticoagulation in Orthopaedic Surgery

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Nikhil A. Thakur, MD, John K. Czerwein, MD, James N. Butera, MD and Mark A. Palumbo, MD J Am Acad Orthop Surg, Vol 18, No 12, December 2010 The orthopaedic patient on chronic anticoagulation therapy is at risk of thromboembolism and hemorrhage in the perioperative period. To establish the most effective anticoagulation regimen, patients should be stratified according to the risk of arterial or venous thromboembolism. Timing of surgery, thromboembolic risk, and bleeding risk should be considered when developing an anticoagulation protocol. Retrievable inferior vena cava filters may be a viable alternative to bridging therapy in patients at high risk of venous thromboembolism and/or bleeding.