Current Trends for Venous Thromboembolic Prophylaxis for Hip Arthroscopy: A Modified Delphi and Nominal Group Technique Consensus Study
Authors: Parsa A, Bedi A, Domb BG
DOI: 10.1093/jhps/hnae014
Journal: Journal of Hip Preservation Surgery, 2024
Objective
To identify current practices and reach expert consensus regarding venous thromboembolism (VTE) prophylaxis following hip arthroscopy.
Methodology
Using modified Delphi and nominal group techniques, 35 high-volume hip arthroscopists participated in a structured survey process to determine areas of agreement and divergence in VTE prophylaxis.
Key Findings
- 91.4% of respondents reported using chemoprophylaxis, with aspirin being the most common agent.
- The duration of aspirin use varied: 65.7% used it for 1 month, 31.4% for 2–3 weeks, and 2.9% for 2–3 months.
- There was strong consensus on the need for prophylaxis in high-risk or complex cases (e.g., prolonged surgery, limited mobility).
- No consensus was reached on perioperative management of oral contraceptives or smoking cessation.
Conclusion
Most high-volume surgeons favor aspirin as a VTE prophylactic following hip arthroscopy, particularly in high-risk patients. However, duration and patient-specific protocols remain variable.
What Does This Mean for Providers?
This study provides a snapshot of evolving consensus in VTE prophylaxis after hip arthroscopy. For providers, the key takeaway is the widespread support for aspirin use, especially in high-risk populations. However, the lack of standardized duration and protocols underscores the need for individualized risk assessment and institution-specific guidelines. Surgeons should remain vigilant in monitoring VTE risk factors while also balancing bleeding risk in this low-incidence but potentially serious complication.