Because a patient faces considerable bleeding during a knee or hip joint replacement (less so with some of the newer minimally invasive approaches), the Orthopedic Surgeon usually has the patient halt any blood thinners. However after surgery, many patients may be asked to take aspirin or more powerful blood thinners.

“Complications from joint replacement are very rare, about 1%-2% of patients,” says McLeod Orthopedic Surgeon Dr. Thomas DiStefano. “Among those potential problems are blood clots – the Deep Vein Thrombosis (DVT) or more serious Pulmonary Embolism (PEs).”

DVTs AND PEs
When a person recovers from surgery, they are in bed or a reclining position. This causes the blood flow to slow, enabling blood clots to form and potentially block a vein. Patients recovering from leg or hip surgery are especially vulnerable to these clots. This represents one reason surgeons and physical therapists urge a patient to start moving and walking as soon as possible after joint replacement surgery.

Pulmonary embolisms, the more serious blood clots, float loose the blood system and end up in the lung, blocking oxygen.

SYMPTOMS
DVTs cause pain in the calf or leg, not related to your incision site. You may also experience redness or tenderness near the knee or swelling in areas form the foot to the thigh.

Pulmonary embolisms give no advance warning until you have trouble breathing, chest congestion/pain or light-headedness due to the lack of oxygen.

PREVENTION & TREATMENT
Treatment for post-surgical blood clots takes several forms:

• Elevating your legs to ease the blood flow back to the heart.
• Lower leg exercise to stimulate blood flow and discourage clots.
• Support stockings, compressing the legs and enhancing blood flow.
• Medication to thin your blood.
  • Aspirin is the most common over-the-counter medication for this purpose.
  • Warfarin (also known as Coumadin), taken as a pill, requires blood tests and monitoring.
  • Low-Molecular Weight Heparin (also known as Lovenox), is given as an injection but requires no monitoring.

Your Orthopedic Surgeon will want to carefully balance the blood thinner so that it does not hinder the healing of your incision.

ACTION YOU CAN TAKE
Before surgery, talk with your Orthopedic Surgeon about what, if any, blood thinning medications you might need following surgery.

After surgery, follow your surgeon’s directions to start moving and walking. Wear the compression socks following surgery. They’re not pretty. But they work.

If you feel the signs of DVTs or a PE, contact your Orthopedic Surgeon immediately. If your breathing problem is severe, call 911.

Find an Orthopedic Specialist near you.

Sources include: McLeod Health. American Academy of Orthopaedic Surgeons, American Association of Hip & Knee Surgeons, National Institutes of Health,National Institute of Arthritis & Musculoskeletal & Skin Diseases