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https://www.readbyqxmd.com/read/29780248/incidence-of-symptomatic-venous-thromboembolism-in-2372-knee-and-hip-replacement-patients-after-discharge-data-from-a-thromboprophylaxis-registry-in-montreal-canada
#1
Andréa Senay, Milanne Trottier, Josée Delisle, Andreea Banica, Benoit Benoit, G Yves Laflamme, Michel Malo, Hai Nguyen, Pierre Ranger, Julio C Fernandes
Background: Low-molecular-weight heparin (LMWH) is a recommended anticoagulant for thromboprophylaxis after major orthopedic surgery. Dabigatran etexilate is an oral anticoagulant recognized as noninferior to LMWH. We aimed to assess the incidence of symptomatic venous thromboembolic events (VTEs) after discharge in patients who underwent joint replacement, using a hospital registry. Patients and methods: Patients who underwent total knee and hip arthroplasty between September 2011 and March 2015 were selected...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29776439/concurrence-of-symmetrical-peripheral-gangrene-and-venous-limb-gangrene-following-polytrauma-a-case-report
#2
Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan, Mahazir Kassim, Theodore E Warkentin
BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses...
May 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29737288/effect-of-different-types-of-anticoagulants-in-the-prevention-of-venous-thrombosis-in-the-operation-of-knee-joint-bone-operation
#3
Wensheng Xu, Tao Zhang, Zenghua Yang, Lin Nie
Deep venous thrombosis is one of the common complications after major surgery in the Department of Orthopedics. The selective knee replacement of the lower extremities is more likely to cause the occurrence of DVT. The most commonly used anticoagulants in the Department of Orthopedics now include low molecular weight heparin (LMWH), Rivaroxaban, ordinary heparin, aspirin and warfarin. At present, the clinical application of low molecular weight heparin is the most, and the effect is the most accurate. This study compared the efficacy and safety of three commonly used anticoagulants such as aspirin, LMWH and Rivaroxaban in preventing VTE after hip and knee arthroplasty, so as to provide a theoretical basis for selecting suitable anticoagulant drugs in clinic...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29735456/effect-of-different-types-of-anticoagulants-in-the-prevention-of-venous-thrombosis-in-the-operation-of-knee-joint-bone-operation
#4
Wensheng Xu, Tao Zhang, Zenghua Yang, Lin Nie
Deep venous thrombosis is one of the common complications after major surgery in the Department of Orthopedics. The selective knee replacement of the lower extremities is more likely to cause the occurrence of DVT. The most commonly used anticoagulants in the Department of Orthopedics now include low molecular weight heparin (LMWH), Rivaroxaban, ordinary heparin, aspirin and warfarin. At present, the clinical application of low molecular weight heparin is the most, and the effect is the most accurate. This study compared the efficacy and safety of three commonly used anticoagulants such as aspirin, LMWH and Rivaroxaban in preventing VTE after hip and knee arthroplasty, so as to provide a theoretical basis for selecting suitable anticoagulant drugs in clinic...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29733996/low-molecular-weight-heparin-for-the-prevention-of-deep-venous-thrombosis-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#5
REVIEW
Ze-Nan Xia, Qing Zhou, Wei Zhu, Xi-Sheng Weng
BACKGROUND: To systematically evaluate the prophylaxis efficacy of low-molecular-weight heparin (LMWH) in the prevention of deep venous thrombosis (DVT) after total knee arthroplasty (TKA). METHOD: PubMed, Cochrane, Embase, Wanfang, CNKI, and VIP databases were searched by index words to identify the eligible RCTs; relevant literature sources were also searched. The latest research was conducted in March 2017. Relative risks (RR), mean difference (MD), and their corresponding 95% confidence intervals (95% CIs) were used to analyze the main outcomes...
May 4, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29708568/preoperative-vitamin-d-deficiency-is-associated-with-higher-postoperative-complication-rates-in-total-knee-arthroplasty
#6
Vishal Hegde, Armin Arshi, Christopher Wang, Zorica Buser, Jeffrey C Wang, Andrew R Jensen, John S Adams, Erik N Zeegen, Nicholas M Bernthal
The purpose of this study was to determine the relative incidence of postoperative complications in 25-hydroxyvitamin D (25D)-deficient and -sufficient patients undergoing total knee arthroplasty (TKA). Patients who were either serum 25D deficient (25D <20 ng/mL) or 25D sufficient (25D ≥20 ng/mL) 90 days prior to primary TKA from 2007 to 2016 were identified using the Humana administrative claims registry. The incidence of postoperative medical and surgical complications was determined by querying for relevant International Classification of Diseases, Ninth Revision and Current Procedural Terminology codes...
April 27, 2018: Orthopedics
https://www.readbyqxmd.com/read/29662786/comparison-of-topical-and-intravenous-administration-of-tranexamic-acid-for-blood-loss-control-during-total-joint-replacement-review-of-literature
#7
REVIEW
Georgi P Georgiev, Panayot P Tanchev, Zlatka Zheleva, Plamen Kinov
Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA) without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use...
April 2018: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29656974/low-dose-aspirin-is-safe-and-effective-for-venous-thromboembolism-prophylaxis-following-total-knee-arthroplasty
#8
Mhamad Faour, Nicolas S Piuzzi, David P Brigati, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Aspirin is an effective prophylaxis for venous thromboembolism (VTE) after total knee arthroplasty (TKA). The optimal prophylactic aspirin dose has not been established. The study aims to compare 2 aspirin regimens with regard to the incidence of (1) symptomatic deep venous thrombosis (DVT), (2) pulmonary embolism (PE), (3) bleeding, and (4) mortality within 90 days after TKA. METHODS: We retrospectively identified 5666 patients who received aspirin twice daily for 4 to 6 weeks after TKA...
March 8, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29628683/short-term-outcomes-of-long-duration-versus-short-duration-tourniquet-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#9
Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay, Manish Kumar Tiwari
Introduction: A tourniquet is used during the total knee replacement surgery to improve the visibility, to reduce the blood loss and for better cementation. Indirectly it decreases the duration of surgery and enhances the recovery of the patient. Their use however is controversial due to some side effects associated with the use of tourniquet. They may increase the risk of deep vein thrombosis and pulmonary embolism by causing venous stasis, endothelial damage and increased platelet adhesion secondary to distal limb ischemia...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29611159/perioperative-outcomes-and-short-term-complications-following-total-knee-arthroplasty-in-chronically-immunosuppressed-patients
#10
Gannon L Curtis, Morad Chughtai, Anton Khlopas, Jared M Newman, Assem A Sultan, Nipun Sodhi, Wael K Barsoum, Carlos A Higuera, Michael A Mont
BACKGROUND: Although there are studies regarding immunosuppressed patients undergoing total knee arthroplasty (TKA) for inflammatory arthritis or osteonecrosis, there is a paucity of studies evaluating immunosuppressed patients undergoing TKA for diagnoses other than these. MATERIALS AND METHODS: We identified all patients undergoing primary TKA for osteoarthritis from 2008-2014 in the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database...
March 29, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29610129/ultrasound-for-lower-extremity-deep-venous-thrombosis-multidisciplinary-recommendations-from-the-society-of-radiologists-in-ultrasound-consensus-conference
#11
REVIEW
Laurence Needleman, John J Cronan, Michael P Lilly, Geno J Merli, Srikar Adhikari, Barbara S Hertzberg, M Robert DeJong, Michael B Streiff, Mark H Meissner
Venous ultrasound is the standard imaging test for patients suspected of having acute deep venous thrombosis (DVT). There is variability and disagreement among authoritative groups regarding the necessary components of the test. Some protocols include scanning the entire lower extremity, whereas others recommend scans limited to the thigh and knee supplemented with serial testing. Some protocols use gray-scale ultrasound alone, whereas others include Doppler interrogation. Point-of-care ultrasound is recommended in some settings, and there is heterogeneity of these protocols as well...
April 3, 2018: Circulation
https://www.readbyqxmd.com/read/29576638/is-combined-administration-of-tranexamic-acid-better-than-both-intravenous-and-topical-regimes-for-total-loss-hidden-loss-and-post-operative-swelling-a-randomized-control-trial
#12
Jatin Prakash, Jong-Keun Seon, Eun-Kyoo Song, Dong-Hyun Lee, Hong-Yeol Yang, Cheng Jin
Background: Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic acid (TXA) in last decade has emerged as an effective and safe way to decrease postoperative bleeding and transfusion rates. Although there is little doubt on the efficacy of the drug, the debate on ideal mode is more recent. We undertook this study to find out the most effective and yet safest way of TXA administration. Materials and Methods: A single institution - two hospital-based, double-blinded, prospective, randomized control trial was conducted from January 2015 to December 2015...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29570760/the-role-of-aspirin-and-unfractionated-heparin-combination-therapy-immediately-after-total-hip-and-knee-arthroplasty
#13
Ali H Sobh, Denise M Koueiter, Anthony Mells, Matthew P Siljander, Mark S Karadsheh
Aspirin and unfractionated heparin (UH) are accepted options for venous thromboembolism (VTE) prophylaxis after total joint arthroplasty (TJA). The use of aspirin in addition to UH in preventing VTE after TJA has yet to be studied. The primary objective of this study was to determine VTE rates in patients receiving aspirin monotherapy and those receiving aspirin and UH combination therapy immediately following TJA. A TJA database from a single hospital system was retrospectively reviewed to identify all patients who underwent primary hip or knee arthroplasty from 2013 to 2016...
March 23, 2018: Orthopedics
https://www.readbyqxmd.com/read/29560401/a-prospective-randomized-comparative-study-of-intravenous-alone-and-combined-intravenous-and-intraarticular-administration-of-tranexamic-acid-in-primary-total-knee-replacement
#14
Paolo Adravanti, Eleonora Di Salvo, Giuseppe Calafiore, Sebastiano Vasta, Aldo Ampollini, Michele Attilio Rosa
Background: Studies on the use of tranexamic acid (TXA) to improve clinical outcomes after joint arthroplasty have reported contrasting results between intravenous (IV) TXA alone and combined IV and intraarticular (IA) administration. We compared the effectiveness of the 2 methods in providing higher postoperative hemoglobin (Hb) levels in patients undergoing primary total knee arthroplasty (TKA). Methods: A total of 100 TKA patients were randomly assigned to receive either IV TXA alone (group 1) or combined IV and topical IA TXA (group 2)...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29549559/no-effectiveness-of-anticoagulants-for-thromboprophylaxis-after-non-major-knee-arthroscopy-a-systemic-review-and-meta-analysis-of-randomized-controlled-trials
#15
REVIEW
Gang Zheng, Qian Tang, Ping Shang, Xiao-Yun Pan, Hai-Xiao Liu
Arthroscopic knee surgery is the most commonly performed orthopedic procedure worldwide and whether thromboprophylaxis should be undertaken after knee arthroscopy is still controversial. To evaluate the efficacy of thromboprophylaxis for deep venous thrombosis (DVT) and venous thromboembolism (VTE) after knee arthroscopic surgery. A meta-analysis was conducted using data from eight randomized trials (4148 patients) to compare thromboprophylaxis with placebo or no prophylactic treatment in patients undergoing knee arthroscopy...
May 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29532455/a-study-of-coagulation-changes-at-early-stage-after-total-knee-arthroplasty
#16
Jian Huang, Peng Zhang, Dawei Wang
Coagulation changes after total knee arthroplasty (TKA) can provide evidence for optimization of timing of perioperative anticoagulation medicine. To evaluate the changes, 50 patients with knee osteoarthritis or rheumatoid arthritis were recruited for the study and underwent thrombelastography tests pre-, 6 hours, 12 hours, and 24 hours after TKA surgery and Doppler ultrasound examination 20 to 24 hours after surgery. The results have shown prolonged clotting time ( R value) at 6 and 12 hours, while shortened at 24 hours...
January 30, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29521284/additional-dose-of-intravenous-tranexamic-acid-after-primary-total-knee-arthroplasty-further-reduces-hidden-blood-loss
#17
Zi-Jian Li, Min-Wei Zhao, Lin Zeng
Background: Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Our previous study suggested that about two-thirds of the total blood loss (TBL) came from hidden blood loss (HBL) on postoperative days 1 and 2...
March 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29518514/a-retrospective-study-comparing-2-approaches-to-catheter-directed-thrombolysis-for-acute-deep-venous-thrombosis
#18
Haiyang Wang, Xiaotong Qi, Yikuan Chen, Jianming Sun
BACKGROUND: To compare the clinical efficacy and safety of catheter-directed thrombolysis (CDT) using the anterior tibial vein approach (ATVA) and popliteal vein approach (PVA) for acute lower-extremity deep venous thrombosis (LEDVT). METHODS: From March 2014 to October 2015, 63 patients with unilateral acute extensive LEDVT were enrolled in this study: 36 patients received CDT via the PVA group, and 27 patients received CDT via the ATVA group. Limb circumference, thrombus score, complications, thrombolytic time, and the amount of thrombolytic agents administered were recorded...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29505518/effectiveness-and-safety-of-an-optimized-blood-management-program-in-total-hip-and-knee-arthroplasty-a-large-single-center-retrospective-study
#19
Shaoyun Zhang, Qiang Huang, Bin Xu, Jun Ma, Guorui Cao, Fuxing Pei
Little has been published on blood management in total hip and knee arthroplasty (THA and TKA, respectively) patients focusing on both hematopoiesis and hemostasis. Our aim was to explore the effectiveness and safety of an optimized blood management program in THA and TKA patients in a large, single-center, retrospective study.We retrospectively reviewed consecutive primary unilateral THA and TKA patients' data at our institution through the National Health Database. They were divided into 3 groups according to an optimized blood management program: group A-combined use of intravenous and topical tranexamic acid (TXA); group B-use of recombinant human erythropoietin (rHuEPO) and iron supplements in addition to treatments in group A; group C-use of additional multiple boluses of TXA in addition to treatments in group B...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29503135/a-prospective-cohort-study-of-symptomatic-venous-thromboembolic-events-in-foot-and-ankle-trauma-the-need-for-stratification-in-thromboprophylaxis
#20
Jose A Blanco, Gemma Slater, Jitendra Mangwani
The incidence of venous thromboembolic (VTE) events (deep vein thrombophlebitis [DVT] or pulmonary embolism [PE]) in foot and ankle trauma has been low, and the risk/benefit ratio associated with chemoprophylaxis is controversial. We compared the 90-day incidence of VTE events in 3 cohorts: group 1, tendo-Achillis (TA) ruptures managed with full weightbearing in a walker boot; group 2, ankle fractures immobilized non-weightbearing in a below-the-knee cast; and group 3, ankle fractures managed surgically, followed by non-weightbearing in a below-the-knee cast...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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