Orthopedic surgery is associated with high incidences of deep venous thrombosis and pulmonary embolism. The need for anticoagulation results in anesthesia issues specifically related to the potential for neuraxial hematomas. Unique complications in orthopedic surgery are related to tourniquet use and fat embolism.This has been driven by multiple factors, including an aging patient population, improvements in the application of regional anesthetic techniques, a greater demand for joint replacement surgery, and advancements in endoscopic techniques, biocompatible materials, imaging equipment, and computer-guided technologies.