When Is It Safe for Patients to Air Travel After Total Hip and Knee Arthroplasty: A Comprehensive Review.

JBJS Rev · Apr 01 2025 · Review

Elmenawi KA, Basit J, Pasqualini I, Khan ST, Nero N, McLaughlin JP, et al.

Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio

Adult Reconstruction

SUMMARY — THE REDUCTIONLimited evidence suggests air travel timing after THA/TKA doesn't clearly affect VTE risk, but long flights (>4 hours) warrant stronger prophylaxis and possible airline medical clearance.
Abstract, as published

» Despite many patients traveling by air for total hip arthroplasty (THA) and total knee arthroplasty (TKA), there are limited data to guide recommendations for air travel after these procedures.» It is unknown whether the timing of postoperative air travel contributes to the risk of developing venous thromboembolism (VTE) after THA and TKA.» The existing limited data do not suggest a difference in VTE risk between those who did and did not travel by air after THA and TKA surgery, mostly within 7 days.» As more patients travel by air seeking THA and TKA, there is an increasing need for a thorough evaluation of associated risks. This assessment should account for patient-specific risk factors, duration of air travel, and the timing of flights in relation to the postoperative period to ensure optimal safety and outcomes.» There is no consensus on the ideal VTE prophylaxis for patients who travel by air after THA and TKA. However, long-haul flights (>4 hours) are associated with a higher VTE risk and are likely to require stronger prophylactic measures.» Some airlines and regulatory agencies may enforce regulations for passengers who travel by air soon after THA and TKA. Patients may be asked to present proof of medical clearance from the treating surgeon before boarding the airplane in addition to being on appropriate VTE prophylaxis.

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