Thromboembolic disease (DVT) is a condition that is a frequent complication of orthopedic surgical care. It is the basis for a significant amount of litigation. The dangers of DVT, its morbidity and mortality can be mitigated by proper prophylaxis, early diagnosis, and recognition of predisposing factors. This condition frequently is seen in adult reconstructive surgery (hip and knee replacement) so I am keenly aware of the prophylaxis techniques, treatment guidelines, and diagnostic interventions for this common condition. It is however; a risk that cannot ever be completely eliminated thus orthopedic surgeons must be constantly vigilant. I have given “grand rounds” presentations to internal medicine residents on this subject yet it is the internist who ultimately will treat the condition once diagnosed.
My experience in this area is not only from my clinical practice. I have been on the speakers’ bureau for pharmaceutical firms that produce the medicines to prevent and treat this condition. I routinely give hospital-based physicians and nursing staff in-service training talks on prevention, diagnosis, and treatment. More importantly I have worked with the hospitals in which I practice to standardize prophylaxis protocols and to insure compliance with governmental and medical professional guidelines to prevent DVT. This level of involvement has given me perspectives on this condition such that colleagues frequently call upon me to advise them on treatment and prevention protocols. I have been asked to serve as the orthopedic expert witness in cases involving this serious condition.
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