Abstract

Total knee arthroplasty (TKA) surgery is a high risk factor for the occurrence of venous thromboembolism. This represents the main preventable cause of death after major orthopedic surgeries, such as joint replacement surgeries, more than a third of affected patients die suddenly or within a few hours after the first manifestation, that is, before even receiving any type of treatment. Given this, this research aimed to identify the most suitable protocol for thromboprophylaxis in patients undergoing total knee arthroplasty. To this end, an exploratory descriptive study was carried out, an integrative review of the literature from the period 2018 to 2023, in the electronic databases Scielo, Pubmed, Google Acadêmico and RBO. To analyze the articles, the flow diagram was used. All research data was analyzed, subsequently tabulated in Word and the results were presented in tables highlighting the main points for better interpretation of the information collected. The results referring to the bibliography reviewed in this study demonstrated that the advent of new oral anticoagulants (NOACs) resulted in greater adherence, without significant loss of efficacy, resulting in a drop in the number of thromboembolic events up to 60 days after the TKA surgical procedure. With the advent of NOACs, the scientific community is still in debate to determine which protocol holds the title of “most efficient”. As this discussion deepened, we began to consider, in addition to the characteristics of each medication, general and individual aspects of patients recommended for the TKA procedure, thus making VTE prevention increasingly individualized. Therefore, it is concluded in this review, that the most efficient hromboprophylactic protocol is related to the individual clinical and physiological conditions of each patient.

Keywords

thromboembolism, arthroplasty, anticoagulants, prophylaxis