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https://www.readbyqxmd.com/read/29156069/the-role-of-intraoperative-intermittent-pneumatic-compression-devices-in-venous-thromboembolism-prophylaxis-in-total-hip-and-total-knee-arthroplasty
#1
Vineet Tyagi, Paul Tomaszewski, Adam Lukasiewicz, Shahana Theriault, Richard Pelker
Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) and total knee arthroplasty (TKA), occurring in up to 85% of patients who are not treated with prophylaxis. The initiation of VTE development may occur intraoperatively. This study investigated whether this gap in VTE prophylaxis can be addressed by the use of intraoperative intermittent pneumatic compression devices (IPCDs) and if intraoperative IPCDs have a meaningful benefit in preventing symptomatic VTE. The authors defined symptomatic VTE as deep venous thrombosis in either lower extremity or a pulmonary embolism...
November 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29112548/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-aspirin
#2
Jean-Yves Jenny, Ingrid Pabinger, Charles Marc Samama
: There is a good rationale for the use of aspirin in venous thromboembolism prophylaxis in some orthopaedic procedures, as already proposed by the 9th American College of Chest Physicians' guidelines (Grade 1C). We recommend using aspirin, considering that it may be less effective than or as effective as low molecular weight heparin for prevention of deep vein thrombosis and pulmonary embolism after total hip arthroplasty, total knee arthroplasty and hip fracture surgery (Grade 1C). Aspirin may be less effective than or as effective as low molecular weight heparins for prevention of deep vein thrombosis and pulmonary embolism after other orthopaedic procedures (Grade 2C)...
November 6, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29092982/multiple-boluses-of-intravenous-tranexamic-acid-to-reduce-hidden-blood-loss-and-the-inflammatory-response-following-enhanced-recovery-primary-total-hip-arthroplasty-a-randomised-clinical-trial
#3
J Xie, Q Hu, J Ma, Q Huang, F Pei
AIMS: The aim of this study was to examine the efficacy and safety of multiple boluses of intravenous (IV) tranexamic acid (TXA) on the hidden blood loss (HBL) and inflammatory response following primary total hip arthroplasty (THA). PATIENTS AND METHODS: A total of 150 patients were allocated randomly to receive a single bolus of 20 mg/kg IV TXA before the incision (group A), a single bolus followed by a second bolus of 1 g IV-TXA three hours later (group B) or a single bolus followed by two boluses of 1 g IV-TXA three and six hours later (group C)...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29092979/aspirin-and-the-prevention-of-venous-thromboembolism-following-total-joint-arthroplasty-commonly-asked-questions
#4
REVIEW
I Azboy, R Barrack, A M Thomas, F S Haddad, J Parvizi
The number of arthroplasties being performed increases each year. Patients undergoing an arthroplasty are at risk of venous thromboembolism (VTE) and appropriate prophylaxis has been recommended. However, the optimal protocol and the best agent to minimise VTE under these circumstances are not known. Although many agents may be used, there is a difference in their efficacy and the risk of bleeding. Thus, the selection of a particular agent relies on the balance between the desire to minimise VTE and the attempt to reduce the risk of bleeding, with its undesirable, and occasionally fatal, consequences...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28984761/effects-of-different-anticoagulant-drugs-on-the-prevention-of-complications-in-patients-after-arthroplasty-a-network-meta-analysis
#5
Ji-Hai Gao, Xiu-Cheng Chu, Lin-Liang Wang, Bo Ning, Chuan-Xin Zhao
BACKGROUND: After arthroplasty treatment, some complications commonly occur, such as early revision, infection/dislocation, and venous thromboembolism (VTE). This study aims to use a network meta-analysis to compare effects of 9 anticoagulant drugs (edoxaban, dabigatan, apixaban, rivaroxaban, warfarin, heparin, bemiparin, ximelagatran, and enoxaparin) in preventing postoperative complications in arthroplasty patients. METHODS: After retrieving PubMed, Embase, and Cochrane Library database from the inception to November 2016, randomized controlled trials were enrolled...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28955681/recent-updates-of-the-diagnosis-and-prevention-of-venous-thromboembolism-in-patients-with-a-hip-fracture
#6
REVIEW
Won Chul Shin, Sang Min Lee, Kuen Tak Suh
Venous thromboembolism (VTE) is a potentially fatal complication that is relatively common after hip surgery. Since patients with a hip fracture have a higher risk of preoperative VTE due to an inability to ambulate after injury and aggravation of underlying age-related conditions, it may be difficult to effectively prevent VTE using only conventional approaches. Very few studies have been published reporting on the prevalence and prevention of VTE in patients with a hip fracture compared to those with hip arthroplasty...
September 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28947374/increased-incidence-of-bleeding-and-wound-complications-with-factor-xa-inhibitors-after-total-joint-arthroplasty
#7
Jonathan H Garfinkel, Brian P Gladnick, Niama Roland, David W Romness
BACKGROUND: Factor-Xa inhibitors have been introduced for prevention of venous thromboembolism (VTE) after joint arthroplasty. However, these agents could also be associated with bleeding or wound complications after surgery. METHODS: We retrospectively reviewed a consecutive series of 59 patients (31 knees, 28 hips) undergoing joint arthroplasty at a high-volume joint arthroplasty referral center, both before and after implementation of a new VTE risk-stratification tool at our institution...
September 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28927565/venous-hemodynamics-after-total-hip-arthroplasty-a-comparison-between-portable-vs-stationary-pneumatic-compression-devices-and-the-effect-of-body-position
#8
Jonathan L Berliner, Philippe A Ortiz, Yuo-Yu Lee, Theodore T Miller, Geoffrey H Westrich
BACKGROUND: Improvements in device design have allowed for portable pneumatic compression devices (PPCDs). However, portability results in smaller pumps that move less blood. Additionally, although patients often stand when wearing PPCDs, few studies have evaluated the hemodynamic effects of PCDs while standing. METHODS: A crossover study was performed to compare a PPCD (ActiveCare+S.F.T.; Medical Compression Systems, Or Akiva, Israel) to a stationary pneumatic compression device (SPCD) (VenaFlow; DJO Global, Carlsbad, CA) on hemodynamics in supine and standing positions among 2 cohorts composed of 10 controls and 10 total hip arthroplasty patients...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28926095/model-based-assessment-using-conventional-bioequivalence-limits-to-ensure-safety-and-efficacy-of-rivaroxaban-in-patients-undergoing-hip-or-knee-replacement
#9
Mario González-Sales, Lanyan Fang, Myong-Jin Kim, Liang Zhao
We evaluated whether the current bioequivalence limit is adequate to ensure safety and efficacy of rivaroxaban in patients under total hip arthroplasty and total knee arthroplasty based on its model informed benefit/risk profile. Clinical data from a total of 7145 patients from 3 phase 2 and 4 phase 3 clinical trials were included in the current model-based exposure-response analysis. The relationships between rivaroxaban exposure measurements (ie, minimum or trough, maximum, average concentration, and area under the concentration-time curve [AUC] at steady state) and clinical outcomes (ie, the probabilities of major bleeding [MB] and venous thromboembolism [VTE]) were modeled using NONMEM 7...
September 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28924075/edoxaban-enhances-thromboprophylaxis-by-physiotherapy-after-total-knee-arthroplasty%C3%A3-the-randomized-controlled-escort-tka-trial
#10
Daisuke Sueta, Koichi Kaikita, Nobukazu Okamoto, Soichiro Yamabe, Masanobu Ishii, Yuichiro Arima, Miwa Ito, Yu Oimatsu, Tatsuro Mitsuse, Satomi Iwashita, Eiichi Nakamura, Seiji Hokimoto, Hiroshi Mizuta, Hisao Ogawa, Kenichi Tsujita
BACKGROUND: The pharmacological advantage of combining physiotherapy with anticoagulants for the prevention of venous thromboembolism (VTE) after total knee arthroplasty (TKA) is not fully known. Herein we investigated the potential benefit of this combination therapy in patients undergoing TKA.Methods and Results:The 38 patients were randomly assigned to a physiotherapy group (n=19) or a physiotherapy plus 30 mg/day edoxaban group (n=19). The occurrence of VTE was evaluated, as were serial changes in parameters measured by the Total Thrombus-formation Analysis System, a novel system for quantitatively analyzing thrombus formation using microchips with thrombogenic surfaces (collagen plus tissue factor, atheroma [AR]-chip)...
September 16, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28878512/comparison-of-postoperative-complications-after-total-hip-arthroplasty-among-patients-receiving-aspirin-enoxaparin-warfarin-and-factor-xa-inhibitors
#11
Perez Agaba, Beau J Kildow, Herman Dhotar, Thorsten M Seyler, Michael Bolognesi
Optimal prophylaxis for prevention of venous thromboembolism (VTE) after total joint arthroplasty (TJA) remains debated. The purpose of this study was to compare postoperative complications in patients receiving different VTE chemoprophylactic regimens. Using a nationwide healthcare database, 72,670 THA patients without a history of VTE were identified. Study cohorts received VTE prophylaxis within 30 days postoperatively. Odds ratios and 95% confidence intervals were used to assess 30-day and 90-day postoperative complications (hematoma, hemorrhage, transfusion, pulmonary embolism (PE), VTE, prosthetic joint infection (PJI), and incision/drainage (I&D))...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28734614/correlation-of-the-caprini-score-and-venous-thromboembolism-incidence-following-primary-total-joint-arthroplasty-results-of-a-single-institution-protocol
#12
Dexter K Bateman, Robert W Dow, Andrzej Brzezinski, Howard Y Bar-Eli, Stephen T Kayiaros
BACKGROUND: Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis, is a serious complication after total joint arthroplasty (TJA). Risk assessment models are increasingly used to provide patient-specific risk stratification. A recently implemented protocol mandates calculation of a Caprini Score for all surgical patients at our institution. We investigated the accuracy of the Caprini Score in predicting VTE events following TJA. METHODS: A retrospective review of patients undergoing primary total hip (THA) and total knee arthroplasty (TKA) over a 1-year time period was performed...
July 5, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28698538/warfarin-should-not-be-used-for-thromboprohylaxis-in-elective-major-orthopaedic-surgery-a-croatian-perspective
#13
Robert Kolundžić, Marijana Šimić Jovičić, Maja Ðinkić, Tadija Petrović, Tomislav Crnković, Vladimir Trkulja
Aim To identify modes of venous thromboembolism (VTE) prophylaxis in patients undergoing elective major orthopaedic surgery (total hip or knee arthroplasty, THA/TKA) at a single university-associated hospital in Croatia. Methods A retrospective analysis of consecutive patients subjected to THA or TKA over a two-year period (2014-2015) with a focus on anticoagulation during the first 15 post-surgical days (period of highest VTE risk). Results Of 603 identified patients three (0.5%) were not anticoagulated (haemophilia) and others received perioperative doses of low molecular weight heparins (LMWH)...
August 1, 2017: Medicinski Glasnik
https://www.readbyqxmd.com/read/28654699/early-mobilisation-after-total-hip-or-knee-arthroplasty-a-multicentre-prospective-observational-study
#14
MULTICENTER STUDY
Matthew J Chua, Andrew J Hart, Rajat Mittal, Ian A Harris, Wei Xuan, Justine M Naylor
OBJECTIVE: Early mobilisation is recommended following total hip arthroplasty (THA) or total knee arthroplasty (TKA) to prevent venous thromboembolism (VTE). We sought to determine the proportions of patients that first mobilised on post-operative day 0 (POD 0) and factors associated with earlier time to mobilisation. METHODS: A prospective cohort study was conducted involving patients with hip or knee osteoarthritis who had undergone primary unilateral THA (n = 818) and TKA (n = 989) at 19 Australian hospitals...
2017: PloS One
https://www.readbyqxmd.com/read/28542415/pharmacological-thromboprophylaxis-and-its-impact-on-venous-thromboembolism-following-total-knee-and-hip-arthroplasty-in-korea-a-nationwide-population-based-study
#15
Ho-Young Yhim, Juhyun Lee, Ji Yun Lee, Jeong-Ok Lee, Soo-Mee Bang
BACKGROUND: Limited data is available regarding the pharmacological prophylaxis for venous thromboembolism (VTE) in Asian patients undergoing total knee arthroplasty or total hip arthroplasty (TKA/THA). METHODS: We performed a population-based epidemiological study using the Health Insurance Review and Assessment Service database to estimate the rate of pharmacological thromboprophylaxis and its impact on VTE in Korean patients who underwent TKA/THA between 2009 and 2013...
2017: PloS One
https://www.readbyqxmd.com/read/28501678/the-risk-of-venous-thromboembolism-with-aspirin-compared-to-anticoagulants-after-hip-and-knee-arthroplasty
#16
Janet N Chu, Judith Maselli, Andrew D Auerbach, Margaret C Fang
BACKGROUND: Recent guidelines include aspirin as an option to prevent venous thromboembolism (VTE) in selected patients undergoing hip or knee replacement surgery. However, the efficacy of aspirin after arthroplasty has not been well-defined, particularly in more contemporary patient populations. We compared rates of post-operative VTE between patients who received aspirin-only versus anticoagulants after hip or knee arthroplasty, using data from a large US-based administrative database...
July 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28486159/trends-of-thromboprophylaxis-and-complications-after-major-lower-limb-orthopaedic-surgeries-in-korea-national-health-insurance-claim-data
#17
Sunyoung Kim, Hongyup Ahn, Soon-Ae Shin, Jong-Heon Park, Chang Won Won
BACKGROUND: In Western countries, prophylaxis for venous thromboembolism (VTE) following major lower limb orthopaedic surgeries is recommended. However, that has not been the case in Asian countries, where the reported incidence of postoperative VTE has been low. The present study examined trends in VTE prophylaxis prescriptions and related complications following major lower limb orthopaedic surgeries in South Korea. DESIGN/PARTICIPANTS: Using claim data from the National Health Insurance Corporation, 263,664 patients aged 65years or older who underwent major orthopaedic surgeries (total hip arthroplasty [THA], total knee arthroplasty [TKA], or hip fracture surgery [HFS]) between 2008 and 2012 were included...
April 26, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28471968/spinal-anesthesia-increases-the-risk-of-venous-thromboembolism-in-total-arthroplasty-secondary-analysis-of-a-j-psvt-cohort-study-on-anesthesia
#18
MULTICENTER STUDY
Mashio Nakamura, Masataka Kamei, Seiji Bito, Kiyoshi Migita, Shigeki Miyata, Kenji Kumagai, Isao Abe, Yasuaki Nakagawa, Yuichiro Nakayama, Masanobu Saito, Takaaki Tanaka, Satoru Motokawa
Clinical guidance on the choice of anesthetic modality vis-à-vis the risk of perioperative venous thromboembolism (VTE) is largely lacking because of a paucity of recent evidence. A comparative effect of general anesthesia and neuraxial blockade on the perioperative incidence of VTE has not been well-investigated.We compared the effects of different types of anesthetic modalities on the risk of VTE after total hip arthroplasty (THA) and total knee arthroplasty (TKA).This is a secondary analysis of the Japanese Study of Prevention and Actual Situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28395685/the-benefit-of-pharmacological-venous-thromboprophylaxis-in-foot-and-ankle-surgery
#19
N P Saragas, P N F Ferrao, B F Jacobson, E Saragas, A Strydom
BACKGROUND: Ten percent of patients with a deep-vein thrombosis (DVT) will develop a fatal pulmonary embolism (PE), often initially asymptomatic. The risks and benefits of pharmacological thromboprophylaxis are well documented in respect of total joint arthroplasty and hip fractures, but little is understood about the incidence of venous thromboembolism (VTE) or the potential risks and benefits of chemoprophylaxis in foot and ankle surgery. OBJECTIVE: To determine whether prophylactic chemoprophylaxis had any impact on the prevention of VTE in a cohort of foot and ankle surgical patients requiring the combination of below-knee cast immobilisation and non-weightbearing for ≥4 weeks...
March 29, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28376907/incidence-of-venous-thromboembolism-and-bleeding-events-in-patients-with-lower-extremity-orthopedic-surgery-a-retrospective-analysis-of-a-japanese-healthcare-database
#20
Takeshi Fuji, Masao Akagi, Yasuyuki Abe, Eisei Oda, Daisuke Matsubayashi, Kaori Ota, Masafumi Kobayashi, Yasuyuki Matsushita, Jumpei Kaburagi, Kei Ibusuki, Atsushi Takita, Mikio Iwashita, Takuhiro Yamaguchi
BACKGROUND: Orthopedic surgeries of lower extremities such as total knee arthroplasty (TKA), total hip arthroplasty (THA), and hip fracture surgery (HFS) are widely considered to carry a high risk of developing deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE). Growing attention to epidemiological studies using a healthcare database led us to quantify the risks using a Japanese database to reveal recent medical care for such events. METHODS: The study comprised 36,947 patients who had undergone orthopedic surgeries of the lower extremities and whose medical information from April 2008 to September 2013 was available...
April 4, 2017: Journal of Orthopaedic Surgery and Research
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