*6.3.4 VTE prophylaxis*

The rate of symptomatic VTE after total hip and knee arthroplasty is approximately 1.9%, with a significant increase of greater than 40% in times where no chemical thromboprophylaxis was used [71, 72]. The National Institute for Health and Care Excellence (NICE) guidelines certifies the use of aspirin, low molecular weight heparin (LMWH), dabigatran, apixaban and rivaroxaban for reducing the incidence of VTE after total knee arthroplasty [73]. In THR, these guidelines support the use of LMWH, dabigatran, apixaban or rivaroxaban [73], with aspirin is not inferior to the other chemical VTE prophylactic agents [74].

Combination of chemical and mechanical thromboprophylaxis is required postoperatively. Ultimately, early mobilisation is significantly influential in reducing the risk of VTE after lower limb total joint arthroplasties, as well as reducing the use of indwelling catheters [75, 76].

We stratify our patients - in easily mobilised patients without other indications for anticoagulants, or past history of thromboembolic disease, we use aspirin 100 mg EC daily, and early mobilisation.
