scholarly journals Aspirin-Persantin Prophylaxis in Elective total hip Replacement

1977 ◽  
Author(s):  
A.J. Silvergleid ◽  
R. Bernstein ◽  
D.S. Burton ◽  
J.B. Tanner ◽  
J.F. Silverman ◽  
...  
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Treated Group ◽  
Control Group ◽  
Double Blind ◽  
Total Hip ◽  
Blind Area ◽  
Effective Prophylaxis ◽  
Clinically Significant ◽  
To Receive

A prospective, double-blind clinical study was performed to evaluate the combination of dipyridamole(Persantin)225 mg/day and acetyl salicyclic acid (ASA) 1 g/day prophylaxis of post-operative venous thromboembolism in elective total hip replacement. Patients were stratified according to age, and randomly assigned to receive drug or placebo. All patients were followed with 125I-labelledfibrinogen scanning for one week post-operatively, or until fully mobile. Venography was performed in 67/129 patients; in 27 patients the venogram was obtained to confirm a positive fibrinogen scan, in 40 patients an elective venogram was obtained on the 7th post-operative day to evaluate the operated thigh (a blind area for scanning). Thrombosis (by scan or venogram) was found in 16/66(24%) in the control group, and in 21/63(33%) in the treated group. Overall incidence was 37/129 (29%). Correlation of scan with venography was 90%. There were no clinically significant pulmonary emboli in either group. We conclude that the combination of ASA and dipridamole as given in this study is not effective prophylaxis in elective total hip replacement.

scholarly journals Aspirin Prophylaxis Against Thromboembolic Disease

1977 ◽  
Author(s):  
W.H. Harris
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Thromboembolic Disease ◽  
Diagnostic Methods ◽  
Control Group ◽  
Fisher Exact Test ◽  
Pulmonary Emboli ◽  
Double Blind ◽  
Total Hip ◽  
Aspirin Prophylaxis

The efficacy and safety of aspirin prophylaxis in preventing deep vein thrombosis is now scientifically established. This was done in a prospective, randomized, simultaneously controlled, double-blind, placebo study using objective diagnostic methods in 98 patients over age 40 undergoing total hip replacement surgery. All patients had fibrinogen uptake tests, cuff impedance phlebography, and radiographic phlebography. The one patient with postoperative pulmonary signs or symptoms had Q/V pulmonary scans and selective pulmonary angiography. Twenty-three of fifty-one patients in the control group developed thromboembolic disease, compared to eleven of forty-seven in the aspirin group (P < 0.02, Fisher Exact Test). The embolus occurred in the control group. There were no deaths. Aspirin was given as 1.2 grams daily starting preoperatively.To study the efficacy of this prophylaxis without the use of early surveillance diagnostic methods, four hundred ninety-eight consecutive patients over 40 years of age undergoing total hip replacement had aspirin prophylaxis but only clinical diagnosis was used. No fatal pulmonary emboli occurred. The only fatality was shown at postmortum not to be caused by an embolus. All patients with pulmonary signs or symptoms had perfusion pulmonary scans. Only seven patients had objectively demonstrated, nonfatal, pulmonary emboli (1.4%).

Effects on Coagulation and Fibrinolysis of Desmopressin in Patients Undergoing Total Hip Replacement

1991 ◽  
Vol 66 (06) ◽  
pp. 652-656 ◽  
Author(s):  
Per Anders Flordal ◽  
Karl-Gösta Ljungström ◽  
Jan Svensson ◽  
Brenda Ekman ◽  
Gustaf Neander
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Bleeding Time ◽  
Antithrombin Iii ◽  
Postoperative Bleeding ◽  
Double Blind ◽  
Total Hip ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Coagulation And Fibrinolysis

SummaryTwelve patients undergoing total hip replacement, with regional anaesthesia and with dextran infusion for plasma expansion and thromboprophylaxis, were given the vasopressin analogue desmopressin (DDAVP) or placebo in a randomized, double-blind prospective study. In controls (n = 6) we found a prolongation of the bleeding time, low factor VIII (FVIII) and von Willebrand factor (vWF) and a decrease in antithrombin III to levels known to be at risk for venous thrombosis. Desmopressin shortened postoperative bleeding time, gave an early FVIII/vWF complex increase, prevented antithrombin III from falling to critically low values and appeared to activate the fibrinolytic system, both by tPA increase and PAI-1 decrease.Thus in the controls we found changes in both coagulation and fibrinolysis indicating a haemorrhagic diathesis as well as a risk for thromboembolism. Desmopressin induced factor changes that possibly reduce both risks.

Low-Dose Heparin and Deep-Vein Thrombosis after Total Hip Replacement

1976 ◽  
Vol 36 (01) ◽  
pp. 157-164 ◽  
Author(s):  
P. M Mannucci ◽  
Luisa E. Citterio ◽  
N Panajotopoulos
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Low Dose ◽  
Control Group ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Dose Heparin ◽  
Deep Vein ◽  
Low Dose Heparin

SummaryThe effect of subcutaneous low-dose heparin on postoperative deep-vein thrombosis (D. V. T.) (diagnosed by the 125I-labelled fibrinogen test) has been investigated in a trial of 143 patients undergoing the operation of total hip replacement. Two randomized studies were carried out: in one the scanning for D.V.T. was carried out daily for 7 days post operatively and in the other for 15 days. In both, the incidence of D.V.T. was significantly lower in the heparin-treated patients (P<0.005). Bilateral D.V.T. was also prevented (P<0.05), through the extension of D.V.T. to the distal veins of the thigh was not significantly reduced. Heparin treatment was, however, followed by a higher incidence of severe postoperative bleeding (P< 0.02) and wound haematoma formation (P< 0.005), and the postoperative haemoglobin was significantly lower than in the control group (P<0.005). A higher number of transfused blood units was also needed by the heparin treated patients (P<0.001).

scholarly journals Balance a few years after total hip replacement

2019 ◽  
Author(s):  
Agnieszka Wareńczak ◽  
Przemysław Lisiński
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Dynamic Balance ◽  
Berg Balance Scale ◽  
Step Test ◽  
Control Group ◽  
Timed Up And Go ◽  
Total Hip ◽  
Functional Reach ◽  
Functional Reach Test

Abstract Background: The aim of the study was to conduct a long-term evaluation of whether total hip replacement permanently affects the quality of postural reactions and body balance. Material and methods: The unilateral Total Hip Replacement (THR) group consisted of 30 subjects (mean age: 69.4). The control group consisted of 30 healthy subjects (mean age: 68.8). The force platform and functional tests such as Timed Up and Go, 3m walk test, Functional Reach Test, 30s Chair Stand Test, Step Test and Berg Balance Scale were used to assess dynamic balance. Results: Subjects from the study group exhibited significantly increased time (p=0.002) and distance (p=0.012) in the tests performed on the force platform compared to the control group. We also observed worse balance and functional test scores in the THR group: Timed Up and Go test (p<0.001), 3m walk test (p<0.001), Functional Reach Test (p=0.003), 30s Chair Stand Test (p=0.002) and Step Test (operated leg: p<0.001, non-operated leg: p=0.002). The results obtained in the Berg Balance Scale tests were not significantly different between the groups (p=0.597). Conclusions: Our research shows that total hip replacement permanently impairs patients’ dynamic balance and functionality in certain lower-extremity activities. Keywords: balance, total hip replacement, gait, muscle strength

scholarly journals 130 Impact of Balance Training in Virtual Reality on Body Balance in Patients after Total HIP Replacement

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv28-iv33
Author(s):  
Anna Hadamus ◽  
Dariusz Białoszewski ◽  
Aleksandra Justyna Kowalska ◽  
Edyta Urbaniak ◽  
Rafał Boratyński ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Control Group ◽  
Forward Movement ◽  
Body Balance ◽  
Total Hip ◽  
Vr Training ◽  
The Impact ◽  
Experimental Group

Abstract Introduction Virtual Reality (VR) training is becoming an increasingly popular form of exercise aiding in re-education of body balance. Many reports have demonstrated its effectiveness, greater patient involvement in exercise and better outcomes compared to traditional rehabilitation [1]. The aim of this study was to assess the impact of the additional training in VR on body balance in patients after total hip replacement. Material and Methods 56 patients randomly assigned to an experimental group (30 people) and a control group (26 people) was included in the study. All patients had undergone THR within 2 to 12 weeks before the beginning of the study. The control group underwent standard post-operative rehabilitation, while a VR training programme was used in the experimental group as an additional rehabilitation tool. Balance was assessed with the VBC system and the AMTi AccuSway plate. The results were considered significant for p &lt;0.05. Results CoP displacement in the frontal plane was reduced in both groups in tests with eyes closed (p&lt;0.05). Other parameters in standing tests remain the same. The maximum forward deflection test has shown a significant increase in the range of forward movement in the experimental group (p &lt;0.05). In the control group, the duration of the forward movement phase was reduced, but the range remained the same. The rhythmic sway test showed an increase in the average speed of movements in the experimental group (p &lt;0.05). There were no changes in the control group. Conclusions 1. Postural stability training in VR primarily involves dynamic aspects of the maintenance of balance. 2. Improvement in functional tests may indicate a better clinical outcome of rehabilitation in patients who have additionally trained in VR. 3. The improvement obtained in static tests most probably results from improvement in muscle strength and static stability resulting from the rehabilitation.

Dabigatran etexilate versus enoxaparin for prevention of venous thromboembolism after total hip replacement: a randomised, double-blind, non-inferiority trial

The Lancet ◽  
2007 ◽  
Vol 370 (9591) ◽  
pp. 949-956 ◽  
Author(s):  
Bengt I Eriksson ◽  
Ola E Dahl ◽  
Nadia Rosencher ◽  
Andreas A Kurth ◽  
C Niek van Dijk ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Dabigatran Etexilate ◽  
Double Blind ◽  
Total Hip

A Comparative Study of the Effectiveness of a Preoperative Education Programme for Total Hip Replacement Patients

1995 ◽  
Vol 58 (12) ◽  
pp. 526-531 ◽  
Author(s):  
Nicola J Spalding
Keyword(s):  
Total Hip Replacement ◽  
Hip Replacement ◽  
Direct Consequence ◽  
Education Programme ◽  
Control Group ◽  
Preoperative Education ◽  
Total Hip ◽  
Quasi Experimental ◽  
Postoperative Morphine ◽  
Experimental Group

This study examined some effects of providing preoperative education to patients prior to their hospital admission for a total hip replacement. The preoperative education programmes are organised and presented by an occupational therapist with the assistance of a physiotherapist, an anaesthetist, an orthopaedic nurse and a dietician. The content includes information on preparation for surgery, what to expect of admission, surgery and rehabilitation, and how to prepare for discharge. A quasi-experimental design was used to compare a group of patients who had attended an education programme with, as control, a group of patients who had not. The variables Investigated were length of hospitalisation, morphine usage, mobility independence and discharge preparation. The results showed that the patients in the experimental group had a mean of 4 days' less hospitalisation than the control group, required less postoperative morphine and achieved mobility independence sooner. The control patients' lack of knowledge of what to expect from their surgery was evident from the lack of preparation for their discharge home. Large financial savings were then calculated as a direct consequence.

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