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Deep venous thrombosis orthopedic surgery

Stavros K Kakkos, Joseph A Caprini, George Geroulakos, Andrew N Nicolaides, Gerard Stansby, Daniel J Reddy, Ioannis Ntouvas
BACKGROUND: It is generally assumed by practitioners and guideline authors that combined modalities (methods of treatment) are more effective than single modalities in preventing venous thromboembolism (VTE), defined as deep vein thrombosis (DVT) or pulmonary embolism (PE), or both. This is an update of the review first published in 2008. OBJECTIVES: The aim of this review was to assess the efficacy of combined intermittent pneumatic leg compression (IPC) and pharmacological prophylaxis versus single modalities in preventing venous thromboembolism...
September 7, 2016: Cochrane Database of Systematic Reviews
Ye Li, Xiang-Hong Guan, Rui Wang, Bin Li, Bo Ning, Wei Su, Tao Sun, Hong-Yan Li
BACKGROUND The aim of this study was to assess the preventive value of active ankle movements in the formation of lower-extremity deep venous thrombosis (DVT), attempting to develop a new method for rehabilitation nursing after orthopedic surgery. MATERIAL AND METHODS We randomly assigned 193 patients undergoing orthopedic surgery in the lower limbs into a case group (n=96) and a control group (n=97). The control group received routine nursing while the case group performed active ankle movements in addition to receiving routine nursing...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Alexander T Reid, Aaron Perdue, James A Goulet, Christopher B Robbins, Aidin Eslam Pour
The complications of emergent or urgent surgery in solid organ transplant recipients are unclear. The goal of this nonrandomized retrospective case study, conducted at a large public university teaching hospital, was to determine the following: (1) 90-day postsurgical complications in solid organ transplant recipients who undergo fracture surgery of the lower extremities; (2) 90-day and 1-year mortality rates for this cohort; (3) correlation of particular postsurgical complications with the 90-day or 1-year mortality rate; and (4) correlation of body mass index with the 90-day or 1-year mortality rate...
July 25, 2016: Orthopedics
Jessica Churchill, Mariano E Menendez, Brent A Ponce
Epilepsy is the most common serious neurological disorder in the United States, but little is known about its effect in the perioperative shoulder surgery setting. The authors sought to determine whether patients with epilepsy undergoing shoulder arthroplasty would be at increased risk for in-hospital adverse events, prolonged length of stay, and nonroutine disposition. Using the National Inpatient Sample (2002-2011), 422,371 adults undergoing shoulder arthroplasty were identified, 3714 (0.9%) of whom had epilepsy...
July 19, 2016: Orthopedics
Dhanesh R Kamerkar, M Joseph John, Sanjay C Desai, Liesel C Dsilva, Sadhna J Joglekar
BACKGROUND AND AIM: There is lack of substantial Indian data on venous thromboembolism (VTE). The aim of this study was to provide real-world information on patient characteristics, management strategies, clinical outcomes, and temporal trends in VTE. SUBJECTS AND METHODS: Multicentre retrospective registry involving 549 medical records of patients with confirmed diagnosis of VTE (deep vein thrombosis [DVT] confirmed by Doppler ultrasonography; pulmonary embolism [PE] by computed tomography, pulmonary angiography and/or V/Q scan) from 2006 to 2010 at three Indian tertiary care hospitals...
March 2016: Indian Journal of Critical Care Medicine
Gaku Matsuzawa, Hirotaka Sano, Hideji Ohnuma, Akihito Tomiya, Yoshiyuki Kuwahara, Chihiro Hashimoto, Itaru Imamura, Satoru Ishibashi, Michio Kobayashi, Masakazu Kobayashi, Tadashi Ishii, Iwao Kaneda, Eiji Itoi
BACKGROUND: In the Great East Japan Earthquake, the Japanese Red Cross Ishinomaki Hospital played an important role as a principal referral center within the Ishinomaki region, one of the most severely affected areas in eastern Japan. The present study describes the patient population, clinical characteristics, and time courses of the medical problems observed at this hospital. METHODS: A retrospective survey of medical logs and records was conducted on the first 2 weeks after the earthquake to characterize orthopedic traumas and related disorders treated during this catastrophe...
July 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Ye Li, Xi-sheng Weng, Jin Lin, Jin Jin, Wen-wei Qian, Bao-zhong Zhang, Peng Gao, Ji-liang Zhai
OBJECTIVE: To investigate the effectiveness of our department's therapeutic regimen and treatment of complications during the perioperative period of hemophilia-related osteoarthropathy. METHODS: In this retrospective study, data on 101 patients with hemophilia who had undergone operative treatment in our hospital from January 2000 to August 2014 were assessed. Ninety-one of the patients had hemophilia A and 10 hemophilia B. All patients were male. Changes in Hospital for Special Surgery (HSS), Harris and American Orthopedic Foot and Ankle Society (AOFAS) scores, occurrence of complications during the perioperative period and the clinical treatment and prognosis pre- and postoperatively and during follow-up were analyzed...
February 2016: Orthopaedic Surgery
Jacob Budny, Joseph Fox, Michael Rauh, Marc Fineberg
Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed and researched orthopedic procedures. As technology and comparative research have advanced, surgical practices have changed to achieve a superior outcome. Our group performed a survey of orthopedic surgeons to evaluate current practice trends and techniques as a follow-up to similar surveys performed in 1999 and 2006. In a survey between 2013 and 2014 consisting of 35 questions regarding the surgical technique, graft choice, fixation method, and perioperative care in ACL reconstruction was sent electronically to the members of the American Orthopaedic Society of Sports Medicine and the Arthroscopy Association of North America...
March 28, 2016: Journal of Knee Surgery
Zilan X Lin, Shane K Woolf
Perioperative bleeding and postsurgical hemorrhage are common in invasive surgical procedures, including orthopedic surgery. Tranexamic acid (TXA) is a pharmacologic agent that acts through an antifibrinolytic mechanism to stabilize formed clots and reduce active bleeding. It has been used successfully in orthopedics to reduce perioperative blood loss, particularly in total hip and knee arthroplasty and spine surgery. Numerous research studies have reported favorable safety and efficacy in orthopedic cases, although there is no universal standard on its administration and its use has not yet become the standard of practice...
March 2016: Orthopedics
Zhongdi Liu, Na Han, Hailin Xu, Zhongguo Fu, Dianying Zhang, Tianbing Wang, Baoguo Jiang
BACKGROUND: Venous thromboembolism is a common postoperative complication following orthopedic surgeries, with morbid and potentially fatal consequences. Perioperative low-molecular-weight heparin (LMWH) therapy can reduce the incidence of venous thromboembolism, but may also increase the risk of bleeding complications. Current literature reflects the need to balance the improved efficacy of early initiating prophylaxis with increased risk of perioperative bleeding. The purpose of this study was to compare the effectiveness and hemorrhage related safety of preoperative versus postoperative LMWH therapy for prevention of deep venous thrombosis (DVT) and pulmonary embolism (PE) in hip fracture patients...
2016: BMC Musculoskeletal Disorders
Zhe Wang, Qian Chen, Mao Ye, Guang-Hui Shi, Bo Zhang
BACKGROUND: Our aim is to investigate the effect of active ankle movement to prevent deep vein thrombosis (DVT) in patients who received lower limb surgery, and to provide a theory of evidence for rehabilitation nursing of patients after orthopedic surgery. METHODS: Between January 2012 and December 2013, a total of 174 patients were randomized as case group (n = 96) and control group (n = 78). Case group received routine nursing and active ankle movement (30 times/min, 1-7 days after surgery), while control group only received routine nursing...
April 2016: Annals of Vascular Surgery
Abby L Ricket, David W Stewart, Robert C Wood, Lyndsey Cornett, Brian Odle, David Cluck, Jessica Freshour, Hadi El-Bazouni
BACKGROUND: The Regulation of Coagulation in Orthopedic Surgery to Prevent Deep Venous Thrombosis and Pulmonary Embolism (RECORD) 1 to 4 trials compared rivaroxaban 10 mg daily with commonly used doses of enoxaparin and demonstrated similar rates of VTE and bleeding. OBJECTIVE: To evaluate bleeding events between patients who received enoxaparin or rivaroxaban for prevention of venous thromboembolism (VTE) following total hip arthroplasty (THA) or total knee arthroplasty (TKA)...
April 2016: Annals of Pharmacotherapy
Andrew J Bryan, Thomas L Sanders, Robert T Trousdale, Rafael J Sierra
Bernese (Ganz) periacetabular osteotomy is associated with significant blood loss and the need for perioperative transfusion. Tranexamic acid decreases blood loss and minimizes transfusion rates in total joint arthroplasty. However, no reports have described its use in patients undergoing Bernese periacetabular osteotomy. This study reports the use of intravenous tranexamic acid in these patients. The study included 137 patients (150 hips) who underwent isolated periacetabular osteotomy at a single institution between 2003 and 2014...
January 2016: Orthopedics
Carlo Rostagno
Despite widespread diffusion of pharmacological prophylaxis, deep venous thrombosis (DVT) is still a common cause of morbidity after major orthopedic surgery (total hip replacement--THR--and total knee replacement--TKR). At present, clear evidence has been provided that pharmacological primary prophylaxis with low molecular weight heparin (LMWH) is associated with a significant decrease in the incidence of venous thromboembolism. The main limitation of LMWH prophylaxis however is the need for parenteral administration with a not negligible drop-out of treatment...
2016: Cardiovascular & Hematological Disorders Drug Targets
Viktor Feldman, Ahmad Biadsi, Omer Slavin, Benjamin Kish, Israel Tauber, Meir Nyska, Yaron S Brin
Sterile elastic exsanguination tourniquets (HemaClear; OHK Medical Devices, Haifa, Israel) are relatively new on the market but are widely used because of the ease and speed of their application. The sterile elastic exsanguination tourniquet consists of a silicon ring wrapped in a stockinet sleeve with pull straps. The physician places the ring on the patient's fingers or toes and then pulls the straps proximally. The silicon ring rolls up the limb, and the stockinet sleeve unrolls onto the limb. During proximal rolling, the device displaces blood out of the limb (exsanguination)...
December 2015: Orthopedics
G I Nazarenko, E B Kleymenova, S A Payushik, V A Otdelenov, D A Sychev, L P Yashina
BACKGROUND: Today medicine is facing a "knowledge crisis" in that explosively expanding medical knowledge encounters limited abilities to disseminate new practices [1]. Clinical practice guidelines (CPGs) are intended to promote high standards of care in specific areas of medicine by summarizing best clinical practice based on careful reviews of current research. However, doctors are often short of time to study these documents and check their updates, have little motivation for strict adherence to them...
2015: International Journal of Risk & Safety in Medicine
Ming Liu, Lei Liu, Fuguo Huang, Yue Fang, Gang Zhong, Xiang Zhou
Deep venous thrombosis (DVT) is an important cause of disability and mortality after major orthopedic surgery. The roles of perioperative treatment and prevention of DVT in patients with femoral neck fractures who require major surgery have not yet been well explored in Chinese clinical practice. Here we report a case of calf muscular venous thrombosis in a 55-year-old woman with femoral neck fracture before surgery. Preventive and treatment measures including the administration of heparin sodium, application of venous foot pump and placement of inferior vena cava filter were taken...
2015: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Funda Büyükyılmaz, Merdiye Şendir, Ricky Autar, İlknur Yazgan
Deep vein thrombosis (DVT) is a prevalent problem for orthopedic patients, particularly owing to the nature of operative interventions and treatment procedures, predisposing to an high risk of DVT. This descriptive study was conducted to determine the levels of risk, the risk factors, and their odds ratio for DVT in patients undergoing major orthopedic surgery. Data were collected using a Patient Information Form and the Autar DVT Risk Assessment Scale (DVTRAS) in orthopedic wards of a university hospital on postoperative day 2...
September 2015: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
Ye Pan, Jun Zhao, Jiacai Mei, Mingzhe Shao, Jian Zhang, Haisheng Wu
OBJECTIVE: To investigate nonpermanent inferior vena cava (IVC) filter in the prevention of perioperative pulmonary embolism (PE) in patients of lower extremity and/or pelvic bone fracture with deep vein thrombosis (DVT). METHODS: Lower extremity or pelvic bone fracture patients with lower extremity DVT hospitalized in our hospital from January 2003 to October 2014 were retrospectively analyzed. Data was analyzed for age, gender, position of fracture, position of proximal of thrombosis, indications of placement, complications, retrieval rate, and rate of entrapped filter clot...
September 2016: Phlebology
Deepak Reddy, Mark M Mikhael, Gary S Shapiro, Tony Farrell
Study Design Case report. Objective Although May-Thurner syndrome or iliac vein compression syndrome is covered in the vascular literature, it remains absent from the orthopedic and neurosurgery literature and has not been previously reported to occur in concordance with spine surgery. We review the salient points of disease presentation, diagnosis, and treatment. Methods A 33-year-old woman was followed postoperatively via clinical and radiographic findings. Her presentation, operative treatment, postoperative extensive deep venous thrombosis (DVT) formation, and management are described...
August 2015: Global Spine Journal
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