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https://www.readbyqxmd.com/read/28222709/combined-application-versus-topical-and-intravenous-application-of-tranexamic-acid-following-primary-total-hip-arthroplasty-a-meta-analysis
#1
Pei Zhang, Yuan Liang, Pengtao Chen, Yongchao Fang, Jinshan He, Jingcheng Wang
BACKGROUND: The use of intravenous (IV) or topical tranexamic acid (TXA) in total hip arthroplasty has been proven to be effective and safe in total hip arthroplasty. However, which of these two administration routes is better has not been determined. The combined administration of TXA has been used in total knee arthroplasty with satisfactory results. We hypothesized that combined application of TXA may be the most effective way without increased rate of thrombotic events such as deep vein thrombosis (DVT) and pulmonary embolisms (PE) in patients subjected to primary total hip replacement (THA)...
February 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28209273/venous-thromboembolic-disease-in-revision-vs-primary-total-knee-arthroplasty
#2
Matthew R Boylan, Dean C Perfetti, Bhaveen H Kapadia, Ronald E Delanois, Carl B Paulino, Michael A Mont
BACKGROUND: Venous thromboembolic disease (VTED) is a serious complication of primary and revision total knee arthroplasty (TKA). However, the incidence and risk of VTED for revision compared with primary TKA cases have not been well-described. METHODS: We identified 225,584 TKAs (208,954 primaries, 16,630 revisions) in the 2003-2012 Statewide Planning and Research Cooperative System database. Odds ratios (ORs) expressed the risk of VTED for revision vs primary TKA, and models were adjusted for age, gender, race, and Charlson comorbidity scores...
January 11, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28185212/economic-evaluations-of-new-oral-anticoagulants-for-the-prevention-of-venous-thromboembolism-after-total-hip-or-knee-replacement-a-systematic-review
#3
REVIEW
James Brockbank, Sorrel Wolowacz
BACKGROUND: Total hip replacement (THR) and total knee replacement (TKR) surgeries are being performed with increasing regularity and are associated with a high risk of developing a venous thromboembolism (VTE). New oral anticoagulants (NOACs) may be more effective at preventing VTEs but are associated with more bleeding events versus traditional anticoagulants. OBJECTIVE: The objective of this systematic review was to identify published economic analyses of NOACs for primary VTE prophylaxis following THR and TKR surgeries, and to summarise the modelling techniques used and the cost-effectiveness results...
February 10, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28174415/comparison-of-enoxaparin-and-rivaroxaban-in-balance-of-anti-fibrinolysis-and-anticoagulation-following-primary-total-knee-replacement-a-pilot-study
#4
Jinwei Xie, Jun Ma, Qiang Huang, Chen Yue, Fuxing Pei
BACKGROUND This study aimed to assess whether the efficacy of tranexamic acid (TXA) would be altered when rivaroxaban or enoxaparin was used for thromboprophylaxis in primary total knee replacement (TKR). It was hypothesized that the hemostatic effect of TXA would be better with the use of enoxaparin. MATERIAL AND METHODS A randomized clinical trial was conducted on 194 patients undergoing primary TKR for osteoarthritis. An intravenous dose of 15 mg/kg (TXA) and 1 g topical TXA were used. Patients randomly received enoxaparin or rivaroxaban prophylaxis when the drainage was less than 30 ml/h 6-8 h postoperatively...
February 8, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28161138/prognosis-of-advanced-tenosynovial-giant-cell-tumor-of-the-knee-diagnosed-during-total-knee-arthroplasty
#5
Pengfei Lei, Rongxin Sun, Hao Liu, Jianxi Zhu, Ting Wen, Yihe Hu
BACKGROUND: Tenosynovial giant cell tumor (TGCT) is a relatively rare disease often misdiagnosed as osteoarthritis. Synovectomy or arthroplasty is the recommended treatment option, but recurrence is common after surgery. This study aimed to determine the prognosis of patients with advanced TGCT that was diagnosed incidentally during total knee arthroplasty (TKA) for osteoarthritis and treated by synovectomy. METHODS: From January 2008 to July 2011, TGCT was diagnosed incidentally in 10 patients (a total of 11 individual knees) undergoing posterior-stabilized TKA for an initial diagnosis of osteoarthritis...
January 11, 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
#6
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...
December 23, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28128085/antiphospholipid-syndrome-with-anti%C3%AE-2glicoprotein-1-antibodies-as-the-cause-of-recurrent-tibial-vein-thrombosis-in-sapho-syndrome
#7
Hanna Przepiera-Będzak, Marek Brzosko
The antiphospholipid antibody syndrome is defined by the presence of antiphospholipid antibodies in patients with recurrent venous or arterial thromboembolism (1). SAPHO syndrome is a rare disease, characterized by specific clinical manifestations of synovitis, acne pustulosis, hyperostosis, and osteitis. It is a disease that manifests with a combination of osseous and articular manifestations associated with skin lesions (2). Venous thrombosis complicating SAPHO syndrome seems to be uncommon with an unclear pathogenesis (3-9)...
December 2016: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28123969/real-time-magnetic-resonance-imaging-of-deep-venous-flow-during-muscular-exercise-preliminary-experience
#8
Arun Antony Joseph, Klaus-Dietmar Merboldt, Dirk Voit, Johannes Dahm, Jens Frahm
BACKGROUND: The accurate assessment of peripheral venous flow is important for the early diagnosis and treatment of disorders such as deep-vein thrombosis (DVT) which is a major cause of post-thrombotic syndrome or even death due to pulmonary embolism. The aim of this work is to quantitatively determine blood flow in deep veins during rest and muscular exercise using a novel real-time magnetic resonance imaging (MRI) method for velocity-encoded phase-contrast (PC) MRI at high spatiotemporal resolution...
December 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28116117/predictive-factors-for-effectiveness-and-safety-of-enoxaparin-for-total-knee-arthroplasty-in-aged-japanese-patients-a-retrospective-review
#9
Akihiro Sonoda, Yuki Kondo, Yasuhiro Tsuneyoshi, Yoshitaka Iwashita, Shoji Nakao, Kazuhisa Ishida, Kentaro Oniki, Junji Saruwatari, Tetsumi Irie, Yoichi Ishitsuka
BACKGROUND: The aims of this study were to investigate predictive factors involved in effectiveness and safety of enoxaparin for prevention of postoperative venous thromboembolism in aged Japanese total knee arthroplasty (TKA) patients. METHODS: Japanese patients over 65 years old who were administered enoxaparin for TKA were enrolled in this study. Their medical records were retrospectively reviewed. Data were corrected at the Izumi Regional Medical Center, from September 2009 to March 2014...
2017: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/28114927/local-anesthetic-infusion-pump-for-pain-management-following-total-knee-arthroplasty-a-meta-analysis
#10
Yeying Zhang, Ming Lu, Cheng Chang
BACKGROUND: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) were to evaluate the effect and safety of local anesthetic infusion pump versus placebo for pain management following total knee arthroplasty (TKA). METHODS: In September 2016, a systematic computer-based search was conducted in the Pubmed, ISI Web of Knowledge, Embase, Cochrane Database of Systematic Reviews. Randomized controlled trials of patients prepared for primary TKA that compared local anesthetic infusion pump versus placebo for pain management following TKA were retrieved...
January 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28102615/comparative-effectiveness-of-venous-thromboembolism-prophylaxis-options-for-the-patient-undergoing-total-hip-and-knee-replacement-a-network-meta-analysis
#11
A Kapoor, A Ellis, N Shaffer, J Gurwitz, A Chandramohan, J Saulino, A Ishak, T Okubanjo, F Michota, E Hylek, T A Trikalinos
: Essentials Despite trial data, guidelines have not endorsed direct oral Xa inhibitors above other options. We provide profiles of venous thromboembolism and hemorrhage risk for 12 options. Direct oral Xa inhibitors had a favorable profile compared with low-molecular-weight heparin. Other options did not have favorable profiles compared with low-molecular-weight heparin. SUMMARY: Background There are numerous trials and several meta-analyses comparing venous thromboembolism (VTE) prophylaxis options after total hip and knee replacement (THR and TKR)...
February 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28053389/is-pre-operative-assessment-of-coagulation-profile-with-thrombelastography-teg-useful-in-predicting-venous-thromboembolism-vte-following-orthopaedic-surgery
#12
Apurve Parameswaran, Vignesh P Krishnamoorthy, Anil T Oommen, Anita Jasper, Ravi J Korula, Sukesh C Nair, Pradeep M Poonnoose
INTRODUCTION: Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication. METHODS: The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053388/prevalence-of-deep-vein-thrombosis-in-patients-with-lower-limb-trauma
#13
Chirag S Kapoor, Ashit K Mehta, Krunal Patel, Paresh P Golwala
INTRODUCTION: Venous thrombo-embolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal condition. According to Western literature, DVT of lower limb veins is one of the most common complications following surgeries for lower limb. Few studies have been published from India on the subject and little is known about the true prevalence of the DVT and hence there are no clear guidelines regarding the prophylaxis for DVT for Indian patients...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#14
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28002368/effect-of-body-mass-index-on-reoperation-and-complications-after-total-knee-arthroplasty
#15
Eric R Wagner, Atul F Kamath, Kristin Fruth, William S Harmsen, Daniel J Berry
BACKGROUND: High body mass index (BMI) is associated with increased rates of complications after total knee arthroplasty. To date, to our knowledge, studies have examined risk as a dichotomous variable using specific BMI thresholds. The purpose of this investigation was to quantify implant survival and the risk of common complications after total knee arthroplasty using BMI as a continuous variable. METHODS: Using prospectively collected data from our institutional total joint registry, we analyzed 22,289 consecutive knees, in 16,136 patients, treated with primary total knee arthroplasty from 1985 to 2012...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28002321/is-combined-topical-with-intravenous-tranexamic-acid-superior-than-topical-intravenous-tranexamic-acid-alone-and-control-groups-for-blood-loss-controlling-after-total-knee-arthroplasty-a-meta-analysis
#16
REVIEW
Chunmei Lin, Yingmei Qi, Li Jie, Hong-Biao Li, Xi-Cheng Zhao, Lei Qin, Xin-Qiang Jiang, Zhen-Hua Zhang, Liping Ma
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy and safety of combined topical with intravenous tranexamic acid (TXA) versus topical, intravenous TXA alone or control for reducing blood loss after a total knee arthroplasty (TKA). METHODS: In May 2016, a systematic computer-based search was conducted in the PubMed, Embase, Cochrane Library, Web of Science, and Chinese Wanfang database...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27986370/effects-of-ethyl-chloride-spray-on-early-recovery-after-total-knee-arthroplasty-a-prospective-study
#17
Wang Rui, Gong Long, Geng Li, Yu Yang, Li Hengjin, Wang Zhenhu
BACKGROUND: Ethyl chloride spray as a common cooling modality has been widely used in acute sports injuries and joint injection procedures. Several clinical studies reported that use of ethyl chloride has positive effects on swelling, pain reduction and recovery from sports injuries. The main aim of present study was to analyze whether postoperative use of ethyl chloride spray benefits results after primary total knee arthroplasty (TKA). METHODS: Between April 1, 2014 and October 21, 2015, 306 subjects undergoing primary TKA used ethyl chloride spray for improving recovery from the damage from surgery...
December 13, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27984847/intraarticular-administration-of-tranexamic-acid-is-safe-and-effective-in-total-knee-arthroplasty-patients-at-high-risk-for-thromboembolism
#18
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Morad Chughtai, Melbin Thomas, Prathik P Mudaliar, Anton Khlopas, Vidur Tangri, Michael A Mont
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent that can be used to reduce blood loss in total knee arthroplasty (TKA) patients. Due to its thrombogenic properties, intravenous (IV) TXA is contraindicated in patients who have an increased risk of arterial or venous thrombosis. For such patients, intraarticular (IA) TXA may be a safe alternative. In this study, we compare: 1) complication rates; 2) intraoperative blood loss; and 3) need for transfusion in TKA patients who received IA TXA versus patients who used IV TXA...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27977593/comparing-efficacy-and-safety-of-2-methods-of-tranexamic-acid-administration-in-reducing-blood-loss-following-total-knee-arthroplasty-a-meta-analysis
#19
COMPARATIVE STUDY
Yu Fu, Zhigang Shi, Bing Han, Yong Ye, Tao You, Juehua Jing, Jun Li
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) were to gather data to evaluate the efficacy and safety of topical tranexamic acid (TXA) versus intravenous (IV) TXA for blood loss after a total knee arthroplasty (TKA). METHODS: Electronic databases: Pubmed, Web of Science, Cochrane library, and Embase from inception to June 2016 were searched. RCTs that comparing topical with IV TXA for blood loss control in patients prepared for TKA were included in this meta-analysis...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27913565/a-24-year-old-male-with-a-painful-and-cold-lower-extremity
#20
Eric A Robinson, Zain I Khalpey, Rajesh Janardhanan
CLINICAL INTRODUCTION: A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses...
December 2, 2016: Heart: Official Journal of the British Cardiac Society
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