Type of Surgery Determines the Best Anticoagulants After Orthopedic Surgery

For patients who undergo major orthopedic operations, the current guidelines do not differentiate between prescribing aspirin and more potent blood thinners for protecting blood clots. This leaves the decision up to individual clinicians. A new analysis published today in the Journal of Hospital Medicine provides much-needed information that summarizes existing studies about which medications are best after different types of surgery.

Every year, hundreds of thousands of Americans undergo major orthopedic surgery such as hip and knee replacements and hip fracture repairs. Patients undergoing such operations are at risk of experiencing serious, potentially fatal blood clots. Attempts to prevent blood clots with medications that thin the blood can be problematic, though, because they can worsen bleeding, which is another serious complication after surgery. Indeed, there is considerable controversy concerning the best type of blood thinner to use: aspirin or stronger blood thinners called anticoagulants. Examples of anticoagulants include heparin and warfarin (Coumadin).