Venous Thromboembolism Prophylaxis Policy - Royal United ...

Appendix 5a: Trauma and Orthopaedic Procedure Specific
Thromboprophylaxis Guideline
Hip surgery prophylaxis
Primary and revision THA
• IPC in theatre
• Early mobilisation
• FID/AES (knee length)/IPC (thigh or knee length) for 48 hours postsurgery
• LMWH (dalteparin) 6-12 hours post-surgery to continue until day 2
• Rivaroxaban starting day 3 post op and continuing for 4 weeks. Dalteparin
where rivaroxaban is contraindicated.
Neck of femur fracture patients
• Ensure adequate hydration
• Dalteparin from day of admission continued for 4 weeks post-surgery
• IPC in theatre
• AES (knee length) / IPC (thigh or knee length) / FID post-surgery
Hip surgery procedures < 60 minutes ie LOW risk:
Hip injections
Hip arthrograms
All other hip surgery procedures take > 60 minutes and are high risk
Knee surgery prophylaxis
Arthroscopy
• Early mobilisation
• AES (knee length) for two weeks post-surgery +/- dalteparin
perioperatively in high risk patients
Ligament reconstruction surgery
• Early mobilisation
• Consider AES (knee length) for two weeks post-surgery
High tibial osteotomy
• Early mobilisation
• AES (knee length) for six weeks post-surgery
Document name: Venous Thromboembolism Prophylaxis Ref.: 795
Issue date: 30 July 2014
Status: Final
Author: Josephine Crowe – Consultant Haematologist Page 44 of 57