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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/28366316/abo-blood-group-is-a-predictor-for-the-development-of-venous-thromboembolism-after-total-joint-arthroplasty
#14
Jared M Newman, Matthew V Abola, Alexandra Macpherson, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: The study's purpose was to determine if there is an association between ABO blood group and the development of symptomatic venous thromboembolism (VTE) after total joint arthroplasty (TJA). METHODS: A total of 28,025 patients who underwent primary TJA at a single health care system from 2000 to 2014 were retrospectively reviewed from electronic records. Patients who experienced a symptomatic VTE were identified. A multivariate regression model adjusted for known potential risk factors, including age, gender, body mass index, surgery type, previous VTE, smokers, rheumatologic diseases, malignancy, hypercoagulable state, and VTE prophylaxis, was developed to test the association of ABO blood group and postoperative VTE...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28262452/tranexamic-acid-was-safe-in-arthroplasty-patients-with-a-history-of-venous-thromboembolism-a-matched-outcome-study
#15
Orlando D Sabbag, Matthew P Abdel, Adam W Amundson, Dirk R Larson, Mark W Pagnano
BACKGROUND: In contemporary total hip arthroplasties (THAs) and total knee arthroplasties (TKAs), intravenous tranexamic acid (IV TXA) has proved efficacious in decreasing blood loss and transfusion. Interested in expanding the use of IV TXA to patients with a prior venous thromboembolic event (VTE), we sought out to determine the risk of recurrent VTE with TXA administration during primary THA and TKA. METHODS: We retrospectively reviewed 1262 patients (1620 cases) with a history of VTE who underwent primary THA or TKA between 2000 and 2012...
September 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28261425/intermittent-pneumatic-compression-for-the-prevention-of-venous-thromboembolism-after-total-hip-arthroplasty
#16
Hong Suk Kwak, Jai Ho Cho, Jung Taek Kim, Jeong Joon Yoo, Hee Joong Kim
BACKGROUND: Venous thromboembolism (VTE) is a relatively common and potentially life threatening complication after major hip surgery. There are two main types of prophylaxis: chemical and mechanical. Chemical prophylaxis is very effective but causes bleeding complications in surgical wounds and remote organs. On the other hand, mechanical methods are free of hemorrhagic complications but are less effective. We hypothesized that mechanical prophylaxis is effective enough for Asians in whom VTE occurs less frequently...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28236550/complications-after-revision-total-hip-arthroplasty-in-the-medicare-population
#17
Sameer Badarudeen, Albert C Shu, Kevin L Ong, Doruk Baykal, Edmund Lau, Arthur L Malkani
BACKGROUND: The purpose of this study was to identify the incidence and types of complications after revision total hip arthroplasty (THA) within the first year, and determine the relative risk factors for these complications and of re-revision. METHODS: The sample size of 5% Medicare claims data from 1998-2011 was studied. Primary THA patients who underwent subsequent revision were identified using ICD-9-CM codes. Outcomes and complications after revision THA were assessed...
February 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28159420/efficacy-in-deep-vein-thrombosis-prevention-with-extended-mechanical-compression-device-therapy-and-prophylactic-aspirin-following-total-knee-arthroplasty-a-randomized-control-trial
#18
RANDOMIZED CONTROLLED TRIAL
Mark A Snyder, Alexandra N Sympson, Christina M Scheuerman, Justin L Gregg, Lala R Hussain
BACKGROUND: Aspirin at 325 mg twice daily is now included as a nationally approved venous thromboembolism (VTE) prophylaxis protocol for low-risk total knee arthroplasty (TKA) patients. The purpose of this study is to examine whether there is a difference in deep vein thrombosis (DVT) occurrence after a limited tourniquet TKA using aspirin-based prophylaxis with or without extended use of mechanical compression device (MCD) therapy. METHODS: One hundred limited tourniquet TKA patients, whose DVT risk was managed with aspirin 325 mg twice daily for 3 weeks, were randomized to either using an MCD during hospitalization only or extended use at home up to 6 weeks postoperatively...
May 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28093896/intravenous-combined-with-topical-administration-of-tranexamic-acid-in-primary-total-hip-arthroplasty-a-randomized-controlled-trial
#19
Yi Zeng, Hai-Bo Si, Bin Shen, Jing Yang, Zong-Ke Zhou, Peng-de Kang, Fu-Xing Pei
OBJECTIVE: Although there are still some controversies, large previous studies have confirmed that intravenous (i.v.) tranexamic acid (TXA) can effectively reduce blood loss and transfusions in total hip arthroplasty (THA) without increasing the risk of deep venous thrombosis. However, few studies have investigated the combination of i.v. and topical application of TXA in primary THA. The purpose of our current study is to examine whether i.v. combined with topical administration of TXA decreases postoperative blood loss and transfusion rates after THA...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28068972/an-underlying-diagnosis-of-osteonecrosis-of-bone-is-associated-with-worse-outcomes-than-osteoarthritis-after-total-hip-arthroplasty
#20
Jasvinder A Singh, Jason Chen, Maria C S Inacio, Robert S Namba, Elizabeth W Paxton
BACKGROUND: Well-designed studies of complications and readmission rates in patients undergoing total hip arthroplasty (THA) with osteonecrosis are lacking. Our objective was to examine if a diagnosis of osteonecrosis was associated with complications, mortality and readmission rates after THA. METHODS: We analyzed prospectively collected data from an integrated healthcare system's Total Joint Replacement Registry of adults with osteonecrosis vs. osteoarthritis (OA) undergoing unilateral primary THA during 2001-2012, in an observational cohort study...
January 9, 2017: BMC Musculoskeletal Disorders
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