Thromboembolic disease in total knee arthroplasty.

Good data exist to support the use of low molecular weight heparins, warfarin, or intermittent pneumatic compression to prevent thromboembolic disease in TKA patients. Emerging data suggest that low molecular weight heparins may be more efficacious than warfarin, but are probably associated with slightly higher bleeding complications. There is little data to support the efficacy of aspirin alone as a prophylactic agent in TKA patients. Routine screening in asymptomatic low risk patients is probably not cost-effective. Prophylactic inferior vena caval filters are recommended in high-risk patients in whom other forms of anticoagulation are not feasible.