By Christopher Pittman, MD, FAVLS, FACR, FACP (Hon). Adapted from his LinkedIn article originally published December 29, 2025.
Si tienes várices and are planning a knee or hip replacement, your leg veins are worth discussing with your doctor before surgery. Varicose veins are more than a cosmetic concern: research has linked them with a higher risk of blood clots after joint replacement.
What the research found before knee replacement
A 2025 matched cohort study in the Journal of Orthopaedics examined 23,190 patients with varicose veins undergoing total knee replacement. Researchers compared 7,730 patients who had previously undergone varicose vein surgery with 15,460 who had not.
During the first 30 days after knee replacement, venous thromboembolism (VTE) occurred in 0.76% of the prior vein-surgery group compared with 1.05% of the comparison group. That is approximately 28% lower relative risk, with an absolute difference of 0.29 percentage points. Lower VTE rates were also observed during later follow-up periods through six months.
What this means for recovery
VTE includes trombosis venosa profunda (TVP), a clot in a deep vein, and pulmonary embolism (PE), a clot that travels to the lungs. The study found lower PE rates in some follow-up periods; DVT rates were comparable between groups.
This was a retrospective observational study. It found an association, rather than proving that vein treatment prevents clots. It focused on knee replacement, so its results should not be treated as a guaranteed benefit for hip replacement or every type of surgery.
Talk with your doctor before joint replacement
If you have varicose veins and an upcoming knee or hip replacement, ask your orthopedic surgeon whether a vein evaluation would be appropriate. Your care team can discuss your individual risk factors and whether any vein treatment belongs in your preparation plan.
For help understanding your vein concerns, contact Vein911 to request an appointment.
Research source
McConnell MJ, et al. Does Surgical Treatment of Varicose Veins Prior to Total Knee Arthroplasty Decrease Rates of Postoperative Venous Thromboembolism? A Matched Cohort Study. Journal of Orthopaedics. 2025;64:169–175. doi:10.1016/j.jor.2025.04.006.
