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Date of Award

Spring 2025

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Zachary Weik DSc, MHS, PA-C

Abstract

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are two common surgical procedures performed by orthopedic surgeons. After these surgeries, a life threatening complication that can occur is venous thromboembolism (VTE) due to multiple factors. Fortunately, there are chemoprophylactic agents that can decrease the chance of VTE occurring post operatively. Multiple guidelines have listed the same chemoprophylactic agents, which include aspirin, warfarin, apixaban, dabigatran, fondaparinux, enoxaparin, low-dose unfractionated heparin, or rivaroxaban. Given these medications for providers to choose from, it is important to pick the most optimal treatment for efficacy and safety. This article will examine the current data on these chemoprophylactic medications to determine the pros and cons of each one, determine the most optimal treatment for efficacy of preventing VTE, and investigate how special patient populations (elderly, obese, and chronic kidney disease) may affect treatment choice.

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Optimal VTE Prophylaxis Post Total Knee and Total Hip Arthroplasty

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are two common surgical procedures performed by orthopedic surgeons. After these surgeries, a life threatening complication that can occur is venous thromboembolism (VTE) due to multiple factors. Fortunately, there are chemoprophylactic agents that can decrease the chance of VTE occurring post operatively. Multiple guidelines have listed the same chemoprophylactic agents, which include aspirin, warfarin, apixaban, dabigatran, fondaparinux, enoxaparin, low-dose unfractionated heparin, or rivaroxaban. Given these medications for providers to choose from, it is important to pick the most optimal treatment for efficacy and safety. This article will examine the current data on these chemoprophylactic medications to determine the pros and cons of each one, determine the most optimal treatment for efficacy of preventing VTE, and investigate how special patient populations (elderly, obese, and chronic kidney disease) may affect treatment choice.