American College of Chest Physicians Guidelines: Advantages and Disadvantages

The American College of Chest Physicians use strict evidence-based medicine methodology to make recommendations regarding deep vein thromboses prophylaxis. The highest level recommendations (1-A) involve routine pharmacoprophylaxis for all total joint patients with protocols that are aggressive by the standards of many arthroplasty specialists. A high incidence of complications has been reported at some centers using 1-A protocols, whereas centers using less aggressive protocols have achieved low complication rates and are also successful in effectively minimizing the incidence of symptomatic thromboembolic events.