What determines the duration of DVT prophylaxis after orthopedic surgery?

• A. Procedure type and patient risk
• B. Surgeon preference only
• C. Age of patient only
• D. Time of day of surgery

Answer: (A)

Duration of DVT prophylaxis after orthopedic surgery is determined by balancing clot prevention with bleeding risk, using both the type of procedure and the patient’s individual risk factors. More extensive or higher-risk surgeries—such as total hip or knee replacement or hip fracture repairs—carry a greater chance of postoperative venous thromboembolism, so they typically require longer prophylaxis, often extending for several weeks. Patient factors that raise VTE risk—previous DVT, cancer, obesity, lengthy immobilization, advanced age, inherited thrombophilias, smoking, or reduced renal function—also push toward longer or more intensive prophylaxis. Conversely, less risky procedures or patients with higher bleeding risk may need shorter durations. This approach, guided by procedure-specific risk and individual patient risk, explains why duration is not decided by surgeon preference, age alone, or time of day of surgery.