Frequency of Vascular Events With Short-term Thromboprophylaxis in Fast-track Hip and Knee-arthroplasty. (FETA)

• Frequency of Vascular events [ Time Frame: 90 days postop ] [ Designated as safety issue: No ]
  Frequency of symptomatic deep venous thrombosis, pulmonary embolus, acute myocardial infarction, ischemic stroke and other vascular events and/or death
  
  

• Risk factors of vascular events [ Time Frame: 90days postop ] [ Designated as safety issue: No ]
  Assessment of preoperative risk factors, and their influence on risk of vascular events after hip and knee arthroplasty
  
  

• bleeding events after total hip or knee arthroplasty [ Time Frame: 2 days after last dose of prophylaxis ] [ Designated as safety issue: Yes ]
  Assessment of any major bleeding events possibly related to thrombosis prophylaxis after surgery
  
  

Major orthopaedic surgery is related to development of thrombosis. It is well known that pharmacological prophylaxis reduces the risk of thrombosis after surgery but there are still doubt about the best type of prophylaxis and duration of treatment. The American College of Chest Physicians recommend thromboprophylaxis with either Low molecular weight heparin, factor Xa-inhibitors or Vitamin-K-antagonists for up til 10 days after total knee replacement (TKR) and 35 days after total hip replacement(THR). However whether these recommendations are applicable in fast-track patients receiving early mobilisation is uncertain.

Studies on fast-track patients receiving early mobilisation and thrombosis prophylaxis only during hospitalisation showed very small incidence of symptomatic thromboembolic events. Therefore we conduct a quality-cohort-study on all patients receiving fast-track TKR/THR with short-term anti-thrombotic treatment, in order to investigate frequency of symptomatical deep vein thrombosis, pulmonary embolus, acute myocardial infarction and stroke.