American Society of Hirudotherapy

Finding the right fit: effective thrombosis risk stratification in orthopedic patients

Research article published in Orthopedics (2000)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewDrug DevelopmentArcelus JI et al. · Orthopedics, 2000

Abstract

Patients undergoing orthopedic surgery are at increased risk of venous thromboembolic events. Proven prophylactic measures are available but are generally underused. However, even one of the most effective therapies available, low-molecular-weight heparin, fails to prevent deep vein thrombosis in approximately 15% of patients undergoing total hip replacement. Clinical outcomes and cost-effectiveness of venous thromboembolism prophylaxis may be optimized by tailoring the treatment to the level of risk of each patient. Overall thromboembolic risk depends on the interactions among multiple factors, such as those that relate to the current clinical status and underlying susceptibility of the patient. Presently, risk assessment models that consider these factors may be of practical assistance in stratifying patients. Improving identification of patients with additional risk factors is a goal of future models. Novel therapies, such as the recombinant hirudin desirudin, or strategies, such as prolonged postoperative prophylaxis, may provide improved protection in these patients and should be considered in the future.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview
Indexed MeSH termsAnticoagulantsHeparin, Low-Molecular-WeightHumansOrthopedic ProceduresPostoperative ComplicationsPredictive Value of TestsRisk AssessmentRisk FactorsVenous Thrombosis

Summary

Finding the right fit: effective thrombosis risk stratification in orthopedic patients.

Why This Matters for Hirudotherapy

This article examines risk stratification strategies for venous thromboembolism prophylaxis in orthopedic surgery patients, noting that even low-molecular-weight heparin fails to prevent deep vein thrombosis in approximately 15% of total hip replacements. The author identifies the recombinant hirudin desirudin as a novel therapy that may provide improved protection in high-risk patients and should be considered in the future. The abstract does not mention leeches, leech therapy, or any leech secretome, so the connection to applied hirudotherapy is not established beyond the mention of a recombinant hirudin drug. The discussion of desirudin is brief and framed as a future strategy rather than an evaluated intervention.

Citation

Finding the right fit: effective thrombosis risk stratification in orthopedic patients

Arcelus JI et al. · Orthopedics, 2000

DOIPubMed

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