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Journal of Long-Term Effects of Medical Implants
SJR: 0.332 SNIP: 0.491 CiteScore™: 0.89

ISSN Print: 1050-6934
ISSN Online: 1940-4379

Journal of Long-Term Effects of Medical Implants

DOI: 10.1615/JLongTermEffMedImplants.2013010092
pages 293-300

Inheritable Risk Factors for Venous Thromboembolism in Patients Undergoing Lower Extremity Total Joint Arthroplasty

D. Alex Stroh
Department of Orthopedics, Union Memorial Hospital, Baltimore, MD
Kimona Issa
School of Health and Medical Sciences, Department of Orthopaedics, Seton Hall University, 400 S Orange Ave, South Orange, New Jersey
Samik Banerjee
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD; Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, Johns Hopkins University, Baltimore, MD
Jesse Allert
Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedic Surgery, South Orange Village, NJ
Eiman Shafa
Seton Hall University, School of Health and Medical Sciences, Department of Orthopaedic Surgery, South Orange Village, NJ
Bhaveen V. Kapadia
Department of Orthopaedic Surgery and Rehabilitation Medicine, SUNY Downstate Medical Center/University Hospital Brooklyn, Brooklyn, NY
Michael A. Mont
Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland

ABSTRACT

Venous thromboembolism is a common and undesirable complication of both total hip and knee arthroplasty. The basic biology and major modifiable risk factors predisposing to thromboembolism are well established, but a complete understanding of the role and management of inherited coagulopathies is lacking. In this manuscript, we have attempted to review the fundamental pathophysiology of the coagulation cascade, analyze recent literature on heritable coagulopathies leading to venous thromboembolism in patients undergoing lower extremity joint arthroplasty, and discuss how an understanding of such factors may affect clinical practice. We advocate that a sound understanding of inherited coagulopathies, as they relate to hip and knee arthroplasty, may help to aid decision making regarding prophylaxis which may eventually lead to an established algorithm system for screening and managing patients at high risk for adverse thromboembolic events.