Yong-Han Cha, Yavuz Saglam, Jun-Il Yoo, Kyung-Hoi Koo.
Response/Recommendation: There is no supportive evidence to modify or change patients’ post-operative rehabilitation with symptomatic venous thromboembolic (VTE) events following total joint arthroplasty (TJA). The postoperative rehabilitation needs not to be modified in symptomatic VTE patients.
Strength of Recommendation: Strong.
Rationale: Patients undergoing orthopaedic surgery are at risk of VTE1-8. Rehabilitation including early ambulation is of utmost importance to prevent VTE9,10. Even with multimodal thromboprophylaxis, some patients undergoing orthopaedic surgery acquire VTE11-13.
A concern: whether the post-operative rehabilitation protocol including early ambulation in symptomatic VTE patients should be changed or not, was raised. To address that concern, we have conducted an extensive search and identified 544 articles: 275 from MEDLINE/PubMed; 237 from EMBASE; nine from the Cochrane Library; and 23 from a hand search. However, we found no study, which reported that the post-operative rehabilitation aggravates the VTE or suggested modifying the post-operative rehabilitation program in symptomatic VTE patients. At this time, there is no evidence to change the rehabilitation in these patients, and the post-operative rehabilitation of patients who have confirmed symptomatic deep venous thrombosis (DVT) need not be modified.
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