Air travel and total joint arthroplasty are both established risk factors for development of venous thromboembolism (VTE); accordingly patients are typically counseled against flying in the early postoperative period. The basis for this recommendation may be unfounded, as the risk of VTE associated with flying in the early postoperative period has not been investigated. This is a case-control study of 1465 consecutive unilateral total hip arthroplasties (THA) and total knee arthroplasties (TKA) performed by a single surgeon over an 18-month period. A multimodal regimen was used for VTE prophylaxis, consisting of early mobilization, mechanical prophylaxis, and chemoprophylaxis according to a risk-stratification model; 96% of patients received aspirin as the sole chemoprophylactic agent. The study population consisted of 220 patients (15.0%) who flew at a mean of 2.9 days after surgery. Patients who elected to fly were encouraged to wear anti-embolic stockings, perform frequent ankle-pump exercises, and move around at least every hour. Mean flight duration was 2.7 hours (range, 1.1 to 13.7 hours). This study population was compared to a control population of 1245 patients (85.0%) who did not fly during this time. Baseline characteristics were similar between the groups, with the exception that the group who flew tended to be older (65.5 vs. 59.5 years, p < 0.001) with a lower body-mass index (28.4 vs. 31.1 kg/m2, p < 0.001).Introduction
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