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Deep venous thrombosis orthopedic surgery

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https://www.readbyqxmd.com/read/29046616/comparison-of-three-different-anti-xa-assays-in-major-orthopedic-surgery-patients-treated-with-direct-oral-anticoagulant
#1
Makoto Ikejiri, Hideo Wada, Shine Tone, Hiroki Wakabayashi, Masahiro Hasegawa, Takeshi Matsumoto, Naoki Fujimoto, Norikazu Yamada, Masaaki Ito, Kaname Nakatani, Akihiro Sudo
BACKGROUND: Measurement of edoxaban plasma concentration has been gathering attention in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE). METHODS: The anti-Xa activity was measured one hour after edoxaban intake using 3 different assays in 200 patients after major orthopedic surgery. RESULTS: The anti-Xa activities on Day 8 were significantly higher than those on Day 4 and those on Day 4 were significantly higher than those on Day 1...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/29035980/incidence-of-symptomatic-pulmonary-embolus-and-deep-vein-thrombosis-after-knee-arthroscopy-in-the-pediatric-and-adolescent-population
#2
Brian C Lau, Jason Jagodzinski, Nirav K Pandya
OBJECTIVE: The incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) after pediatric knee arthroscopy is unknown. The purpose of this study was to determine the incidence of venous thromboembolism (VTE) after knee arthroscopy in the pediatric and adolescent population in a high-volume center. DESIGN: Retrospective cohort study. SETTING: Tertiary care children's hospital. PATIENTS: All patients who underwent arthroscopy of the knee for a sports-related injury by 2 surgeons were reviewed...
October 10, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28891865/opioid-prescription-levels-and-postoperative-outcomes-in-orthopedic-surgery
#3
Crispiana Cozowicz, Ashley Olson, Jashvant Poeran, Eva E Mörwald, Nicole Zubizarreta, Federico P Girardi, Alexander P Hughes, Madhu Mazumdar, Stavros G Memtsoudis
Given the basic need for opioids in the perioperative setting, we investigated associations between opioid prescription levels and postoperative outcomes using population-based data of orthopedic surgery patients. We hypothesized that increased opioid amounts would be associated with higher risk for postoperative complications. Data were extracted from the national Premier Perspective database (2006-2013); N = 1,035,578 lower joint arthroplasties and N = 220,953 spine fusions. Multilevel multivariable logistic regression models measured associations between opioid dose prescription and postoperative outcomes, studied by quartile of dispensed opioid dose...
December 2017: Pain
https://www.readbyqxmd.com/read/28877326/upper-extremity-deep-venous-thrombosis-prophylaxis-after-elective-upper-extremity-surgery
#4
Kunal K Sindhu, Brian Cohen, Travis Blood, Joseph A Gil, Brett Owens
Historically, upper extremity deep venous thromboses (DVTs) have been rare; however, their incidence has increased as awareness has increased. Patients who develop upper extremity DVTs often have multiple comorbidities. However, in the past decade, studies have found a small risk of upper extremity DVTs associated with orthopedic procedures involving the upper extremity. The risk of complications following a DVT, including postthrombotic syndrome and pulmonary embolism, is substantially higher with a DVT of the upper extremity compared with a DVT of the lower extremity...
September 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28869359/monitoring-of-hemostatic-abnormalities-in-major-orthopedic-surgery-patients-treated-with-edoxaban-by-aptt-waveform
#5
M Hasegawa, H Wada, S Tone, T Yamaguchi, H Wakabayashi, M Ikejiri, M Watanabe, N Fujimoto, T Matsumoto, K Ohishi, Y Yamashita, N Katayama, A Sudo
INTRODUCTION: An analysis of the activated partial thromboplastin time (APTT) in major orthopedic surgery patients receiving edoxaban for the prevention of venous thromboembolism (VTE) was carried out. METHODS: The APTT waveform was analyzed in the above patients to monitor edoxaban administration. RESULTS: Of these 99 patients, 12 exhibited deep vein thrombosis, and 25 had massive bleeding. An increased biphasic pattern of the APTT waveform was observed after the administration of edoxaban, but there were no significant differences between the patients with and without complications...
September 4, 2017: International Journal of Laboratory Hematology
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
#6
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...
December 2017: Internal and Emergency Medicine
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
#7
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/28336037/deep-vein-thrombosis-and-pulmonary-embolism-considerations-in-orthopedic-surgery
#8
REVIEW
Jasmine Saleh, Mouhanad M El-Othmani, Khaled J Saleh
Patients undergoing orthopedic surgery have an increased risk for deep venous thrombosis (DVT) and pulmonary embolism (PE). These complications are considered detrimental, as they cause major postoperative morbidity and mortality and lead to a substantial health care burden. Because of the high incidence and serious nature of these complications, it is essential for orthopedic surgeons to have a comprehensive knowledge of the risk factors, diagnosis, and treatment of acute DVT and PE. Perioperative management of orthopedic patients to prevent postoperative DVT and PE and optimize postoperative outcomes is also discussed in this review...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#9
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/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#10
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27776901/bilateral-total-hip-arthroplasty-1-stage-or-2-stage-a-meta-analysis
#11
REVIEW
Hongyi Shao, Chi-Lung Chen, Mitchell G Maltenfort, Camilo Restrepo, Richard H Rothman, Antonia F Chen
BACKGROUND: Total hip arthroplasty (THA) is one of the most successful orthopedic surgeries performed in the last 50 years. However, controversies still exist between conducting 1- or 2-stage bilateral THA. METHODS: Using PubMed, Ovid, Embase, and Cochrane library databases, we searched for papers written between January 1995 and October 2015 that contained the following search terms: "one-stage or two-stage" or "simultaneous or staged," and "hip" and "arthroplasty or replacement...
February 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27600864/combined-intermittent-pneumatic-leg-compression-and-pharmacological-prophylaxis-for-prevention-of-venous-thromboembolism
#12
REVIEW
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
https://www.readbyqxmd.com/read/27600467/active-ankle-movements-prevent-formation-of-lower-extremity-deep-venous-thrombosis-after-orthopedic-surgery
#13
RANDOMIZED CONTROLLED TRIAL
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...
September 7, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27459137/complicated-outcomes-after-emergent-lower-extremity-surgery-in-patients-with-solid-organ-transplants
#14
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...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27458894/early-postoperative-complications-after-shoulder-arthroplasty-in-patients-with-epilepsy
#15
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...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27076726/arrive-a-retrospective-registry-of-indian-patients-with-venous-thromboembolism
#16
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
https://www.readbyqxmd.com/read/27067290/patient-trends-in-orthopedic-traumas-and-related-disorders-after-tsunami-caused-by-the-great-east-japan-earthquake-an-experience-in-the-primary-referral-medical-center
#17
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
https://www.readbyqxmd.com/read/27028382/perioperative-period-of-a-hemophilia-related-osteoarthropathy-therapeutic-regimen-and-analysis-of-complications
#18
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
https://www.readbyqxmd.com/read/27018510/emerging-trends-in-anterior-cruciate-ligament-reconstruction
#19
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...
January 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/26942474/safety-efficacy-and-cost-effectiveness-of-tranexamic-acid-in-orthopedic-surgery
#20
REVIEW
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
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