Why do I have to stop taking my blood thinners before knee surgery?

Dr. Rishi G. Anand, MD
Cardiac Electrophysiologist

If you suffer from atrial fibrillation (afib) or are taking blood thinners (anticoagulants), you will be taken off blood-thinning medications before knee surgery to avoid bleeding and serious complications. Because even though knee surgery is a non-cardiac surgery, you can still have cardiac complications if you suffer from afib.

The management of anticoagulation when you are undergoing surgical procedures is challenging because interrupting anticoagulation for a procedure increases your risk of forming blood clots that can be carried to other vessels in your body (thromboembolism), which can lead to a more serious condition or death. At the same time, surgery and invasive procedures have associated bleeding risks that are increased by the anticoagulant(s) you take for thromboembolism prevention. A balance between reducing the risk of thromboembolism and preventing excessive bleeding must be reached.

If you are being treated for afib and will be undergoing any type of surgery, talk your doctor about management of your afib and blood thinners around the time of surgery.

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