Hypercoagulable Disorders in Orthopaedics: Etiology, Considerations, and Management

JBJS Rev. 2021 Oct 12;9(10). doi: 10.2106/JBJS.RVW.21.00079.

Abstract

»: Hypercoagulable disorders (HCDs) can be inherited or acquired. An HCD of either etiology increases the chance of venous thromboembolic events (VTEs).

»: Patients with an HCD often have the condition discovered only after surgical complications.

»: We recommend that patients with a concern for or a known HCD be referred to the appropriate hematological specialist for workup and treatment.

»: Tourniquet use in the orthopaedic patient with an HCD is understudied and controversial. We recommend that tourniquets be avoided in the surgical management of patients with an HCD, if possible. When tourniquets are applied to patients with unknown HCD status, close follow-up and vigilant postoperative examinations should be undertaken.

MeSH terms

  • Humans
  • Orthopedic Procedures* / adverse effects
  • Orthopedics*
  • Tourniquets / adverse effects
  • Venous Thromboembolism* / etiology
  • Venous Thromboembolism* / therapy
  • Venous Thrombosis*