Pulmonary Embolism Prevents Recovery From Joint Repacement Surgery

Case Overview

This case involves a female patient who underwent a total knee replacement. After surgery, the patient was not given Coumadin, and instead received aspirin in order to prevent excess clotting. While in the hospital, she developed tachycardia and shortness of breath. Despite these symptoms, which eventually subsided, the patient was discharged from the hospital. After her symptoms returned shortly after discharge, she was admitted to another hospital where he was diagnosed with a pulmonary embolus. She was treated with Xarelto and had to remain hospitalized for an extended period of time, thereby hindering her ability to recover from his original surgery. Later on, the patient consulted with several specialists who recommended a revision of the knee replacement.

Questions to the Orthopedic Surgery expert and their responses

Do you routinely perform total knee replacement surgeries?

I perform total knee replacements on a weekly basis. I have published and lectured extensively on this subject.

After this kind of surgery, does a patient receive deep vein thrombosis prophylaxis? Is aspirin considered an appropriate medication for deep vein thrombosis prophylaxis?

After this kind of surgery a patient should always receive deep vein thrombosis prophylaxis. The fact that the patient was given aspirin instead of something else can be due to a number of surgical or patient related factors, however her symptoms before discharge should have been cause for concern.

Can the complication of pulmonary embolus and the patient's subsequent prolonged hospitalization have impeded the rehabilitation and recovery process?

The complication of pulmonary embolus and the patient's subsequent prolonged hospitalization could have impeded the rehabilitation and recovery process. An incomplete rehabilitation and recovery process can require a patient to undergo additional surgical interventions for their knee, as appears to have happened in this case.

About the expert

This highly qualified expert earned his medical degree at the prestigious Harvard University. He went on to complete a residency in Orthopedic Surgery at the University of Pennsylvania and a fellowship in adult lower extremity reconstruction at the Mayo Clinic. He has published over 80 journal articles and more than 15 book chapters. This expert currently serves at the Director of the Center for Hip Preservation at an Ivy League Academic Hospital.