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New research · Internal Medicine
Medicina (Kaunas, Lithuania) · 3h
Systematic reviewMedicina (Kaunas, Lithuania) · 2026

Thromboprophylaxis After ACL Reconstruction: Controversies and Future Challenges.

Theodoros Bouras, Panagiotis Antzoulas, Vasileios Giannatos … Vasileios Chouliaras
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Internal MedicineSystematic review
“

Current evidence does not support universal thromboprophylaxis following anterior cruciate ligament reconstruction. A risk-stratified approach is recommended, with mechanical measures or aspirin for low-to-moderate-risk patients and LMWH or DOACs for high-risk individuals. Future research may focus on genetic and patient-specific factors to better explain existing heterogeneity.

Thromboprophylaxis After ACL Reconstruction: Controversies and Future Challenges.

Theodoros Bouras … Vasileios Chouliaras
Medicina (Kaunas, Lithuania) · 2026
Background

Anterior cruciate ligament reconstruction (anterior cruciate ligament reconstruction) is a very common procedure in young, active individuals.

Purpose

This review aims to summarize key international recommendations to support clinical decision-making.

Methods

Rather than performing a systematic review, relevant documents were identified from official publications, consensus statements, and registry-based recommendations issued by recognized orthopaedic and thrombosis-related organizations.

More results

This narrative review identified nine major international guidelines addressing thromboprophylaxis in anterior cruciate ligament reconstruction.

Most guidelines, including CHEST and NICE, advise against routine anticoagulation for low-risk patients, reserving it for those with specific risk factors.

More results

While ICM-VTE supports the use of aspirin or LMWH in high-risk cases, SFAR stands out by recommending routine LMWH for all patients.

HAOST emphasizes early mobilization and selective prophylaxis, including aspirin for low-risk groups.

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