Inheritable risk factors for venous thromboembolism in patients undergoing lower extremity total joint arthroplasty

Venous thromboembolism is a common and undesirable complication of both total hip and knee arthroplasty. The basic biology and major modifiable risk factors predisposing to thromboembolism are well established, but a complete understanding of the role and management of inherited coagulopathies is lacking. In this manuscript, we have attempted to review the fundamental pathophysiology of the coagulation cascade, analyze recent literature on heritable coagulopathies leading to venous thromboembolism in patients undergoing lower extremity joint arthroplasty, and discuss how an understanding of such factors may affect clinical practice. We advocate that a sound understanding of inherited coagulopathies, as they relate to hip and knee arthroplasty, may help to aid decision making regarding prophylaxis which may eventually lead to an established algorithm system for screening and managing patients at high risk for adverse thromboembolic events.