Risk-stratified TJA perioperative antithrombotic management protocols require prognostic evidence

Summary: When people get a new hip or knee, they face a hidden danger: dangerous blood clots. To stop these clots, doctors give patients blood thinners. However, medical experts are arguing about the best way to choose which medicine to use.

Right now, some medical guidelines ignore real-world data and only look at strict, controlled studies. This is a problem because different patients need different treatments. For example, for a healthy person with a low risk of clots, simple aspirin works perfectly. It is cheap, effective, and less likely to cause dangerous bleeding. But for high-risk patients—like those who have had clots before—aspirin isn't strong enough. They need heavier blood thinners, even though those drugs come with a higher risk of bleeding and infection.

Doctors are calling for personalized, "risk-stratified" plans. This means looking at a patient's unique medical history to balance the risk of clots against the risk of bleeding. Studies show that when doctors use a personalized plan and keep patients on the right medicine for 90 days, the number of dangerous blood clots drops significantly.

For more details, see rssapp-aaos-org-aaosnow at aaos.org/aaosnow/2026/may/commentary/commentary02/ (opens in new tab)