Anticoagulation Therapy

Phlebitis (inflammation of the veins of the legs) or Deep Vein Thrombosis (DVT), which refers to blood clotting in the veins of the leg, is a possible risk after total joint replacement surgery.

For the prevention of Deep Vein Thrombosis (DVT) after surgery, many patients will be prescribed an oral anticoagulant. The purpose of an oral anticoagulant is to prevent your blood from clotting.

Type of medication

Depending on your medical condition and/or preference of your surgeon, you will be prescribed with either buffered aspirin twice a day or warfarin, for anticoagulation, or an injection. If you are prescribed warfarin, daily blood tests will be necessary to determine the dosage of medication required. Upon discharge home, weekly or bi-weekly blood tests will continue for the duration of the therapy. Your primary medical doctor or orthopedic surgeon will adjust the dose accordingly.

If you are prescribed Coumadin® postoperatively, the venipuncture technician will draw your blood daily so we can monitor your PROTIME. If you are prescribed injections, the nurse will educate you how to do them at home prior to discharge.

The PROTIME Test measures the time it takes for a clot to form. Your doctor may compare your time to a standard, then determine the effect Coumadin® has had on your clotting time, and adjust your dosage accordingly.

Testing for Deep Vein Thrombosis to monitor Coumadin® usage

Depending upon your surgeon’s preference, an Ultrasound Doppler Test or Venogram may be ordered. Both tests are described on the following page.

If your Doppler or Venogram result is negative for DVT, then Coumadin® therapy may be discontinued by your doctor when you are discharged from the hospital.

If your Doppler or Venogram result is positive for a DVT, you will probably continue to receive Coumadinℜ for another 6-12 weeks by prescription.

If you go home on Coumadin® therapy, you will require routine monitoring of your PROTIME level. Your nurse, professional care coordinator and doctor will provide further instructions.

Special Tests to Evaluate Deep Vein Thrombosis (Blood Clotting)

Testing for Deep Vein Thrombosis by the Doppler or Venogram tests described here will depend upon your surgeon’s practice.

The Ultrasound Doppler Test:

This is a non-invasive test for detecting Deep Vein Thrombosis. The test creates and measures sound waves generated by moving blood cells.

The patient lies in the semi-upright position for the examination. There is no discomfort or special preparation for this test. The staff will discuss the results and any indicated treatment with you.

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