Expansion of vein thrombosis and embolism remains a serious problem in traumatology and orthopedics up to the present day. Maintaining the balance between the efficiency of thromboprophylaxis and the danger of post operative hemorrhage can be achieved only when the prevention medication, its dose and the duration of use have been correctly chosen. An anticoagulant of the new generation (Pradaxa), per oral direct thrombin inhibitors dabigatran etexilate to the utmost complies with the above specified requirements that are why the authors decided in favor of its use in everyday clinical practice. A primary test for open use of dabigatran in 48 patients who underwent hip or knee arthroplasty has been carried out. Taking into account the highest risk of thromboembolic complications after large joints plasty, the method of mechanical prophylaxis DVT - electro neurostimulation of shin muscles has been introduced into clinical practice. According to the results of follow-up of the patients, who received different anticoagulants, the algorithm of an anticoagulant’s choice has been developed in various kinds of clinical situations with the possibility of changing injectable preparation to per oral forms. Convenience of per oral administration and predictability of dabigatran effect made it possible to provide consistency of hospital and out-patient stages of treatment, which also contributed to the reduction of thromboembolic complications, especially at an out-patient stage.