Thromboelastography for the Orthopaedic Surgeon

John C. Hagedorn II, MD; James M. Bardes, MD; Creed L. Paris, MD; Ronald W. Lindsey, MD, FACS


J Am Acad Orthop Surg. 2019;27(14):503-508. 

In This Article


Many areas exist wherein TEG could be used to advance or improve orthopaedic knowledge and ultimately improve patient care. The limited exploration of TEG in orthopaedic surgery, in contrast to other medical specialties, is largely because of lack of familiarity and the quite recent expansion of indications for this test. However, TEG can be seen as both valuable and indispensable because it can rapidly and accurately provide a detailed picture of a patient's coagulation profile, resulting in better use of blood products and ultimately allowing patient-specific blood product use. By decreasing the expense of used blood product, blood bank inventory, and prevention of complications from anticoagulation therapy, the investment in TEG equipment/maintenance and employee training could ultimately be seen as a long-term cost-reducing measure. In these ways, TEG fills a niche as an adjunct to CCT in the orthopaedic trauma setting and high blood loss orthopaedic surgery, allowing coagulation profiles to be followed in real time to more accurately define and manage the dynamic situation of the bleeding orthopaedic patient.