What is the evidence?
Venous thrombosis and pulmonary embolism continue to be significant complications of hip or knee replacement surgery. Seven to 10 days of anticoagulant prophylaxis starting before or soon after surgery fail to prevent 20%–30% of venous thromboembolic events. It is this residual thrombosis rate that provides a spur for adding pre-discharge screening to routine prophylaxis, with the aim of detecting and treating silent thrombosis before it progresses to clinical disease.
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The author has received consulting fees for participating in clinical trial steering committees (from Sanofi, Bristol-Myers Squibb, Bayer and Organon) and expert committees (from AstraZeneca, Bayer and CSL).