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Concern for deep vein thrombosis (DVT) is the most common reason for emergency department (ED) referral after total joint arthroplasty (TJA) at our institution. We aim to investigate the referral pathway, together with the cost and outcomes associated with patients who access an ED because of concern for DVT after TJA. We reviewed a consecutive series of all primary hip and knee arthroplasty patients who accessed the ED for concern for DVT within 90 days of surgery over a one-year period. The referral source and costs associated with the