is it necessary to remove varicose veins prior to orthopaedic surgery to reduce the risk for thromboembolic complications? a vascular surgeon’s perspective

Hip and knee joint arthroplasty is associated with a high incidence of thromboembolic complications, with lower extremity varicose veins presumed as one of the risk factors. For a multitude of reasons, the removal of varicose veins in all patients prior to orthopaedic surgery is not achievable. This study analyses the available data regarding the impact of removing lower extremity varicose veins or failure to operate them in the group of patients requiring large-scale orthopaedic surgery. At present, there are no studies that could allow us to determine the exact conditions under which surgical management of lower extremity varicose veins prior to total hip or knee arthroplasty is necessary. Individual findings suggest that such treatment prior to orthopaedic surgery may be beneficial for patients, whilst indicating the need for further research. Researchers emphasise that at present antithrombotic prophylaxis should be applied in accordance with the existing recommendations, based on adequate risk assessment, e.g. according to the Caprini risk assessment model, where the presence of varicose veins is associated with a score of 1 point.