Meta-Analysis on Medical Management vs Non-Pharmacological Therapy of (DVT) Deep Venous Thrombosis After Orthopedic Procedures

Abstract

Background: Postoperative deep venous thrombosis is a clinically important complication after orthopedic surgery and may progress to pulmonary embolism if not prevented effectively. Objective: This systematic review compared pharmacological, non-pharmacological, and combined prophylactic strategies for prevention and management of DVT after orthopedic procedures. Methods: A systematic comparative review was conducted using studies published from 2013 to 2026 across Frontiers in Medicine, ScienceDirect, SpringerLink, Wiley Online Library, Cureus, and Acta Orthopaedica Belgica. Eligible studies included postoperative orthopedic patients receiving pharmacological, mechanical, rehabilitation-based, or combined thromboprophylaxis and reporting DVT, pulmonary embolism, bleeding, adverse events, adherence, or recovery-related outcomes. Results: Sixteen studies were included in the qualitative synthesis, with eight considered potentially suitable for quantitative synthesis after verification of event-level data. Pharmacological prophylaxis, including low-molecular-weight heparin, aspirin, and direct oral anticoagulants, was consistently reported as effective for DVT prevention but raised bleeding-related concerns. Non-pharmacological strategies, including compression stockings, intermittent pneumatic compression, early mobilization, physiotherapy, and rehabilitation nursing, demonstrated favorable safety and supportive preventive value. Conclusion: Individualized multimodal thromboprophylaxis appears clinically appropriate after orthopedic surgery, but formal pooled estimates require complete extraction of study-level outcome data.