Antithrombotic Therapy in patients undergoing Joint Replacement Surgery - How Common is it?

Abstract

Introduction: It is common for patients on antithrombotic therapy to undergo joint replacement surgeries nowadays. This study aimed to document the locoregional prevalence and to explore whether there is an increasing number of these patients. Materials and Methods: Patients who underwent elective primary total knee replacement (TKR) and primary total hip replacement (THR) surgeries in 2007 and 2012 in Queen Mary Hospital were searched via the electronic clinical management system. The electronic patient records were reviewed to identify those who were on antithrombotic therapy. Data of these patients were then analysed using IBM SPSS Statistics v21.0. Statistical significance was performed using Pearson Chi-square test. Results: A total of 131 patients (mean age, 64.8 years; 61.8% with TKR and 38.2% with THR) and 324 patients (mean age, 67.9 years; 78.4% with TKR and 21.6% with THR) received total joint replacement surgeries in 2007 and 2012, respectively. The proportion of patients who were on antithrombotic therapy was significantly higher in 2012 (16%) compared with that in 2007 (8.4%) [p = 0.032]. The most common antithrombotic therapy was aspirin monotherapy (88.9%). The most common indication for antithrombotic therapy was ischaemic heart disease (44.4%). Discussion and Conclusion: There is an increasing trend of patients undergoing total joint replacement surgeries who are on antithrombotic therapy. It is increasingly important for the orthopaedic surgeon to be familiar with the perioperative management of patients on antithrombotic therapy.