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https://www.readbyqxmd.com/read/28899592/the-american-college-of-surgeons-national-surgical-quality-improvement-program-surgical-risk-calculator-has-a-role-in-predicting-discharge-to-post-acute-care-in-total-joint-arthroplasty
#1
Daniel E Goltz, Billy T Baumgartner, Cary S Politzer, Marcus DiLallo, Michael P Bolognesi, Thorsten M Seyler
BACKGROUND: Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. METHODS: A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014...
August 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28865588/the-effect-of-active-toe-movement-atom-on-calf-pump-function-and-deep-vein-thrombosis-in-patients-with-acute-foot-and-ankle-trauma-treated-with-cast-a-prospective-randomized-study
#2
Ben A Hickey, Andrew Cleves, Raza Alikhan, Neil Pugh, Len Nokes, Anthony Perera
BACKGROUND: Patients with foot and ankle trauma treated with cast are advised to perform toe movements to prevent venous thromboembolism (VTE). Our aim was to determine the effect of active toe movement on asymptomatic deep vein thrombosis (DVT) and venous calf pump function. METHODS: Patients aged 18-60 years with acute foot and ankle trauma requiring below knee non weight bearing cast were randomized to intervention (regular active toe movement) or control groups (n=100)...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28863078/the-prevalence-of-chronic-deep-venous-thrombosis-in-trauma-implications-for-hospitals-and-patients
#3
Kathleen A Cannon, Jayraan Badiee, James D Wallace, Jason B Brill, Michael J Sise, Vishal Bansal, C Beth Sise, Steven R Shackford
INTRODUCTION: Deep venous thrombosis (DVT) is considered a preventable complication in trauma patients. Hospitals risk financial penalties for DVT rates above accepted benchmarks. These penalties do not apply to chronic DVT which develop prior to admission. Lower-extremity duplex ultrasound (LEDUS) can detect characteristics of thrombus chronicity, allowing differentiation of chronic from acute DVT. The objective of this study was to determine the prevalence of chronic DVT in hospitalized trauma patients...
August 31, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28836570/thirty-day-postoperative-complications-following-primary-total-knee-arthroplasty-a-retrospective-study-of-incidence-and-risk-factors-at-a-single-center-in-china
#4
Bin Feng, Jin Lin, Jin Jin, Wen-Wei Qian, Wei Wang, Xi-Sheng Weng
BACKGROUND: Total knee arthroplasty (TKA) may be associated with serious complications that adversely affect outcomes and increase the likelihood of disability. However, few studies with sufficient sample size have reported postoperative complications following TKA among Chinese patients. This study aimed to evaluate complications of TKA within 30 postoperative days and to identify the related risk factors. METHODS: A retrospective complication-based analysis of TKA using the arthroplasty registry between 2008 and 2013 was performed by summarizing complications of TKA within 30 postoperative days...
August 16, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28780771/low-molecular-weight-heparin-for-prevention-of-venous-thromboembolism-in-patients-with-lower-limb-immobilization
#5
REVIEW
Aniek Ag Zee, Kelly van Lieshout, Maaike van der Heide, Loes Janssen, Heinrich Mj Janzing
BACKGROUND: Immobilization of the lower limb is a risk factor for venous thromboembolism (VTE). Low molecular weight heparins (LMWHs) are anticoagulants, which might be used in adult patients with lower-limb immobilization to prevent deep venous thrombosis (DVT) and its complications. This is an update of the review first published in 2008. OBJECTIVES: To assess the effectiveness of low molecular weight heparin for the prevention of venous thromboembolism in patients with lower-limb immobilization in an ambulatory setting...
August 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28766070/prothrombin-time-international-normalized-ratio-is-a-useful-marker-for-edoxaban-efficacy-in-preventing-venous-thromboembolism-after-total-knee-arthroplasty
#6
Kazuki Kodato, Kazunari Ishida, Nao Shibanuma, Akihiko Toda, Koji Takayama, Shinya Oka, Shinya Hayashi, Shingo Hashimoto, Masahiro Kurosaka, Ryosuke Kuroda, Tomoyuki Matsumoto
BACKGROUND: Deep vein thrombosis (DVT) is one of the main complications following total knee arthroplasty (TKA). In this study, oral administration of 15 mg edoxaban (a factor Xa inhibitor) once daily for 14 days efficiently prevented the incidence of DVT. Our hypothesis was that prothrombin time-international normalized ratio (PT-INR) on the third postoperative day could predict the incidence of DVT following TKA. METHODS: In this study, 286 subjects were enrolled and divided into two groups according to the presence or absence of DVT...
August 1, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28765007/combined-intravenous-topical-and-oral-tranexamic-acid-administration-in-total-knee-replacement-evaluation-of-safety-in-patients-with-previous-thromboembolism-and-effect-on-hemoglobin-level-and-transfusion-rate
#7
Joris A Jansen, Joost R C Lameijer, Barbara A M Snoeker
BACKGROUND: The aims of this study were to investigate the safety of combined intravenous, oral and topical tranexamic acid (TXA) in primary total knee replacement. We assessed dose-related efficacy on hemoglobin level, transfusion, length of stay and thromboembolic complications. In addition, TXA safety in patients with previous history of thromboembolism >12months ago was monitored specifically. METHODS: From January 2013 until January 2016, 922 patients were included who received TXA after primary total knee replacement...
July 29, 2017: Knee
https://www.readbyqxmd.com/read/28759944/impact-of-health-utility-after-thrombotic-complications-following-total-hip-and-knee-arthroplasty
#8
Bikram Karmakar
BACKGROUND: Medical complications and preexisting conditions frequently place the surgeon in the unenviable position of choosing between the serious and potentially life-threatening effects of thrombosis, or the issue of bleeding and surgical site complications. The aim of this research was to determine if health utility could be a consideration before choosing to therapeutically anticoagulate in the hip and knee arthroplasty patient. METHODS: The quantitative risks and effectiveness of treatment options for venous thromboembolism, atrial fibrillation, acute coronary syndromes, ischaemic stroke and mechanical heart valves were evaluated from previously published data...
July 31, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28756546/thromboprophylaxis-with-enoxaparin-and-direct-oral-anticoagulants-in-major-orthopedic-surgery-and-acutely-ill-medical-patients-a-meta-analysis
#9
Claudio Cimminiello, Paolo Prandoni, Giancarlo Agnelli, Giovanni Di Minno, Hernan Polo Friz, Francesco Scaglione, Patrizia Boracchi, Giuseppe Marano, Job Harenberg
Subjects undergoing major orthopedic surgery and acutely ill hospitalized medical patients represent a population at medium-high risk for venous thromboembolism (VTE). They are treated with low molecular weight heparin (LMWH) and direct oral anticoagulants [DOACs] for VTE prevention. We conducted a meta-analysis of phase III randomized clinical trials evaluating LMWH enoxaparin versus DOACs for prophylaxis of VTE by combining studies including patients undergoing elective total hip and knee replacement surgery, and acutely ill hospitalized medical subjects...
July 29, 2017: Internal and Emergency Medicine
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
#10
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/28710707/prescription-patterns-of-non-vitamin-k-oral-anticoagulants-across-indications-and-factors-associated-with-their-increased-prescribing-in-atrial-fibrillation-between-2012-2015-a-study-from-the-norwegian-prescription-database
#11
Anna Maria Urbaniak, Bjørn Oddvar Strøm, Randi Krontveit, Kristin Helene Svanqvist
OBJECTIVE: We studied prescription patterns for non-vitamin K oral anticoagulants (NOACs) in Norway between 2012 and 2015, and compared NOAC and warfarin patient characteristics such as age, gender and cardiovascular (CV) co-medications across reimbursed indications. Factors associated with NOAC prescribing in atrial fibrillation (AF) were also analysed. METHODS: All Norwegian patients (N = 156,124) who received at least one dispensed NOAC or warfarin prescription within the indications of AF, deep vein thrombosis and pulmonary embolism (DVT_PE) or prevention of venous thromboembolic events after a hip or knee surgery (VTE_surg) between 2012 and 2015 were included in the study...
August 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28699943/dosing-accuracy-of-direct-oral-anticoagulants-in-an-academic-medical-center
#12
Janice Schwartz, Steve Merrill, Noelle de Leon, Ashley Thompson, Margaret Fang
BACKGROUND/OBJECTIVE: Direct-acting oral anticoagulants (DOACs) are increasingly used to prevent or treat thromboembolism. We conducted a study to compare how well initial DOAC prescribing for adult inpatients adhered to dosing recommendations approved by the US Food and Drug Administration (FDA). DESIGN: Retrospective analysis. SETTING: Single academic medical center, July 1, 2014 to June 30, 2015. PATIENTS: 508 adult inpatients...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28697863/intra-articular-application-is-more-effective-than-intravenous-application-of-tranexamic-acid-in-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#13
Jin Wang, Qiaojie Wang, Xianlong Zhang, Qi Wang
BACKGROUND: The optimal administration route of tranexamic acid (TXA) in total knee arthroplasty (TKA), and the effect of TXA on hidden blood loss and total blood loss are undetermined. The purpose of this study was to compare the effectiveness of intravenous versus intra-articular application of tranexamic acid in patients undergoing knee arthroplasty. METHODS: A total of 150 patients undergoing primary unilateral total knee arthroplasty were randomly distributed to 3 groups (IV, intra-articular, and control group; each 50 patients) and administrated TXA (1 g IV and 50 mL intra-articular saline, 1 g intra-articularly and 50 mL intra-articular saline, and 0 g and 50 mL intra-articular saline, respectively)...
June 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28658157/efficacy-of-tranexamic-acid-plus-drain-clamping-to-reduce-blood-loss-in-total-knee-arthroplasty-a-meta-analysis
#14
REVIEW
Yan Zhang, Jun-Wei Zhang, Bao-Hua Wang
BACKGROUND: Perioperative blood loss is still an unsolved problem in total knee arthroplasty (TKA). The efficacy of the preoperative use of tranexamic acid (TXA) plus drain-clamping to reduce blood loss in TKA has been debated. This meta-analysis aimed to illustrate the efficacy of TXA plus drain-clamping to reduce blood loss in patients who underwent a TKA. METHODS: In February 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28637438/the-efficacy-and-safety-of-tranexamic-acid-in-revision-total-knee-arthroplasty-a-meta-analysis
#15
Peng Tian, Wen-Bin Liu, Zhi-Jun Li, Gui-Jun Xu, Yu-Ting Huang, Xin-Long Ma
BACKGROUND: There is no consistent conclusion regarding the efficacy and safety of the intravenous administration of tranexamic acid (TXA) for reducing blood loss in revision total knee arthroplasty (TKA). We performed a meta-analysis of comparative trials to evaluate the efficacy and safety of TXA in revision TKA. METHODS: We conducted a search of PubMed, EMBASE, The Cochrane Library and Web of Science for randomized controlled trials (RCTs) and non-RCTs. Two authors selected the studies, extracted the data, and assessed the risk of bias independently...
June 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28634095/comparative-effectiveness-and-safety-of-drug-prophylaxis-for-prevention-of-venous-thromboembolism-after-total-knee-arthroplasty
#16
Guy Cafri, Elizabeth W Paxton, Yuexin Chen, Craig T Cheetham, Michael K Gould, Janet Sluggett, Stefano A Bini, Monti Khatod
BACKGROUND: Rates of venous thromboembolism in contemporary studies of primary total knee arthroplasty (TKA) have been reported to be as high as 3.5%. Although drug prophylaxis is effective, the best option among these regimens is not well established. The purpose of this study was to evaluate the comparative effectiveness and safety of aspirin, low-molecular-weight heparin, synthetic pentasaccharide factor Xa inhibitors, and vitamin K antagonist. METHODS: Data were from a US total joint replacement registry, with 30,499 patients receiving unilateral TKA from May 16, 2006, to December 31, 2013...
May 31, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28633148/clinical-and-functional-results-of-119-patients-with-knee-dislocations
#17
Nicholas R Scarcella, Douglas S Weinberg, Stephen Bowen, Heather A Vallier
OBJECTIVES: To describe clinical results and functional outcomes of knee dislocations treated with a consistent strategy within our institution. DESIGN: Retrospective case series. SETTING: Level 1 trauma center. PATIENTS: One hundred nineteen patients were treated at one institution between 2000 and 2014 for knee dislocation. MAIN OUTCOME MEASUREMENTS: Knee range of motion, functional instability, and complications were recorded...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28614226/tranexamic-acid-plus-diluted-epinephrine-versus-tranexamic-acid-alone-for-blood-loss-in-total-joint-arthroplasty-a-meta-analysis
#18
REVIEW
Zhanxia Yu, Lulan Yao, Qin Yang
BACKGROUND: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)). METHODS: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28598560/effects-of-unilateral-tourniquet-used-in-patients-undergoing-simultaneous-bilateral-total-knee-arthroplasty
#19
Pei-Lai Liu, De-Qiang Li, Yuan-Kai Zhang, Qun-Shan Lu, Liang Ma, Xue-Zhi Bao, Meng Zhang
OBJECTIVE: To assess the benefits of use of a tourniquet in one limb in patients undergoing simultaneous bilateral total knee arthroplasty (TKA). METHODS: A prospective randomized trial was designed to evaluate the outcomes of unilateral tourniquet use during simultaneous bilateral TKA. A total of 52 (36 women and 16 men) patients with osteoarthritis who underwent simultaneous bilateral primary TKA between January 2010 and January 2015 were assigned randomly to tourniquet (TG) or non-tourniquet (NG) groups prior to surgery...
May 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28567578/the-efficacy-and-safety-of-multiple-dose-intravenous-tranexamic-acid-on-blood-loss-following-total-knee-arthroplasty-a-randomized-controlled-trial
#20
Yiting Lei, Jinwei Xie, Bin Xu, Xiaowei Xie, Qiang Huang, Fuxing Pei
PURPOSE: To assess the efficacy and safety of multiple-dose intravenous tranexamic acid (IV-TXA) on blood loss following total knee arthroplasty (TKA). METHODS: One hundred fifty nine patients received one bolus of IV-TXA before skin incision and two boluses three and six hours later (group A), or another bolus nine hours later (group B), or another two boluses nine and 12 hours later (group C). The primary outcomes were total blood loss (TBL), hidden blood loss (HBL), and maximum haemoglobin (Hb) drop...
May 31, 2017: International Orthopaedics
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