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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can A Knee Replacement Surgery Be Done While On Effient?

I am possibly going to have a knee replacement. I am taking effient after having 3 stents placed in my heart. My cardiac doctor said a clot formed on one of my stents and he went in and removed it the same day of surgery. This was in February of this year, 2016. My cardiac doctor said he would prefer not to have any surgeries and I should remain on the blood thinner for life. He said if I intend to have the knee replacement I must realize it could increase the chance of heart attack. The surgeon said he has done 10.000 knee replacements and at least 500 with stents and he feels it is safe. Cardiac doctor said be off effient 7 days before surgery, the surgeon who will do the knee replacement says only 5 days. Do you agree not to have the surgery or ok? If ok, off 5 or 7days. I take an 81mg aspirin as well.
Tue, 6 Dec 2016
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General & Family Physician,  's  Response
Hi. Sorry to hear about your problem. So far as your question is concern if you need a joint replacement surgery then you need to stay away from a blood thinner agent for almost a week. 5 or 7 days difference is not that much important to worry about. You can choose a duration in between. It is just a rough estimate. Also you need to understand that it may increase the risk of a heart problem but not necessarily you are going to have to have an attack. There is a little bit increase in relative risk. So if you really need the surgery, you can go for it. Keeping an eye on INR , maintaining it between 1.5-2.5 would be good option to maintain a balance between pros. and cons. of both staying away from a blood thinner (increased risk for cardiac event) and the surgery related risk of bleeding. Hoping these lines might help you to make a better decision.
Regards.
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Can A Knee Replacement Surgery Be Done While On Effient?

Hi. Sorry to hear about your problem. So far as your question is concern if you need a joint replacement surgery then you need to stay away from a blood thinner agent for almost a week. 5 or 7 days difference is not that much important to worry about. You can choose a duration in between. It is just a rough estimate. Also you need to understand that it may increase the risk of a heart problem but not necessarily you are going to have to have an attack. There is a little bit increase in relative risk. So if you really need the surgery, you can go for it. Keeping an eye on INR , maintaining it between 1.5-2.5 would be good option to maintain a balance between pros. and cons. of both staying away from a blood thinner (increased risk for cardiac event) and the surgery related risk of bleeding. Hoping these lines might help you to make a better decision. Regards.