scholarly journals New Oral Anticoagulants for Thromboprophylaxis after Elective Total Hip and Knee Arthroplasty

Thrombosis ◽  
2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Richard J. Friedman
Keyword(s):  
Knee Arthroplasty ◽  
Vitamin K Antagonists ◽  
Fixed Dose ◽  
Dose Titration ◽  
Total Hip ◽  
Coagulation Monitoring ◽  
Increased Risk ◽  
Anticoagulant Drugs ◽  
Venous Thromboembolic Events ◽  
Hip And Knee Arthroplasty

Anticoagulant drugs reduce the risk of venous thromboembolic events after total hip and knee arthroplasty. However, the use of current drugs, such as low molecular weight heparins, is hampered by their subcutaneous route of administration. The use of vitamin K antagonists is hampered by the requirement for routine coagulation monitoring and dose titration to provide effective anticoagulation without an increased risk of bleeding and numerous food and drug interactions. Clearly, there is a need for new oral, fixed-dose anticoagulant drugs that do not require coagulation monitoring, while demonstrating similar or better efficacy and safety profiles when compared with current agents.

Patients With Multiple Sclerosis are at Increased Risk for Postoperative Complications Following Total Hip and Knee Arthroplasty

2019 ◽  
Vol 34 (8) ◽  
pp. 1606-1610 ◽  
Author(s):  
Nicole Durig Quinlan ◽  
Dennis Q. Chen ◽  
Brian C. Werner ◽  
C. Lowry Barnes ◽  
James A. Browne
Keyword(s):  
Multiple Sclerosis ◽  
Postoperative Complications ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty

scholarly journals POS0098 THE INFLUENCE OF THE ACTIVITY OF RHEUMATOID ARTHRITIS TO INFECTIOUS AND WOUND COMPLICATIONS AFTER TOTAL HIP AND KNEE ARTHROPLASTY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 259.2-259
Author(s):  
A. Khramov ◽  
M. Makarov ◽  
S. Makarov ◽  
S. Maglevaniy ◽  
E. Naryshkin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Knee Arthroplasty ◽  
Periprosthetic Infection ◽  
Underlying Disease ◽  
Infectious Complications ◽  
Wound Complications ◽  
Activity Levels ◽  
Total Hip ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty

Background:Surgical treatment of patients with rheumatoid arthritis (RA) is associated with an increased risk of complications. This is due to the presence of inflammation, many variants of the disease, reduced physical activity, severity of functional disorders, prolonged therapy with glucocorticoids, disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs, osteoporosis, as well as activity of the underlying disease.Objectives:to conduct a comparative analysis of the influence of RA activity levels on infectious complications (periprosthetic infection) and wound complications (poor healing, divergence, necrosis of the wound edges) after hip and knee arthroplasty in RA patients.Methods:1113 arthroplasties were analyzed in patients with RA, which were performed between 2002 and 2019. Of these, 649 total knee arthroplasties and 464 total hip arthroplasties were performed.Results:Infectious complications after total hip and knee arthroplasty did not occur at 0 grade of disease activity (remission). At the I grade of activity, periprosthetic infections were detected with a frequency of 0.31%, at the II grade – 0.89%, and at the III level in 3.06% of cases.Complications from the operative wound occurred in 0.91% of cases with I grade of activity, at II grade with a frequency of 5.68%, and at III – 6.98%. There were no cases of complications from the wound in patients with remission of RA.Statistical analysis of the obtained data revealed a significantly higher number of complications in the group of RA patients (p<0.005). During analyzing each type of complication, significant differences were also obtained (p<0.005).Conclusion:Risk of periprosthetic infection and complications from the wound is several times higher in patients with a high grade of RA activity. This means that performing arthroplasty, as well as other operations, in patients with high RA activity correlates to a high risk of complications.Disclosure of Interests:None declared

Urinary Self-Catheterization is Not Associated with Increased Risk of Major Complications Following Total Hip and Knee Arthroplasty

2020 ◽  
Vol 35 (9) ◽  
pp. 2380-2385
Author(s):  
Alyssa D. Althoff ◽  
Dennis Q. Chen ◽  
Nicole D. Quinlan ◽  
Brian C. Werner ◽  
James A. Browne
Keyword(s):  
Knee Arthroplasty ◽  
Total Hip ◽  
Major Complications ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty

scholarly journals Outcome of total hip and knee arthroplasty in HIV-infected patients: A systematic review

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Shane C. O'Neill ◽  
Joseph M. Queally ◽  
Anne Hickey ◽  
Kevin J. Mulhall
Keyword(s):  
Systematic Review ◽  
Knee Arthroplasty ◽  
Normal Population ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Hiv Positive ◽  
Significant Heterogeneity ◽  
Total Hip ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty

Significant advances in the treatment of Human Immunodeficiency Virus (HIV) have occurred in recent times, with life expectancy now approaching the normal population. Therefore, patients with HIV will increasingly be undergoing joint replacement in the future, however concerns remain regarding the complications and outcome in this patient cohort. The aim was to assess the outcome of total hip and knee arthroplasty in HIV-infected patients. A systematic search of the literature using MOOSE reporting guidelines was performed to assess the outcome of hip and knee arthroplasty in HIV-infected patients. The primary outcome was infection. Secondary outcome was all-cause revision. The search yielded 552 results, of which 19 met the inclusion criteria, comprising 5.819.412 joint replacements. The overall quality of the studies was poor with significant heterogeneity between the studies. Infection and revision appeared to be more likely to occur in HIV positive patients compared to HIV negative patients. A subgroup analysis of four studies revealed a risk ratio of 3.31 and 2.25 for increase in infection and revision respectively in HIV positive patients. This systematic review and meta-analysis demonstrates an increased risk of infection and revision in HIV infected patients undergoing total hip and knee arthroplasty. However, these findings are based on poor quality evidence in a limited number of studies and need to be interpreted with caution. Further research should concentrate on large, well-designed, prospective studies, that control for co-morbidities and employ standardised outcome measures to allow for direct comparison.

Combined total hip and knee arthroplasty during the same hospital admission

2019 ◽  
Vol 101-B (5) ◽  
pp. 573-581
Author(s):  
A. M. Almaguer ◽  
K. H. Cichos ◽  
G. McGwin Jr ◽  
J. M. Pearson ◽  
B. Wilson ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Joint Infection ◽  
Hospital Costs ◽  
Revision Arthroplasty ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Prosthetic Joint ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty ◽  
Deep Vein

Aims The purpose of this study was to compare outcomes of combined total joint arthroplasty (TJA) (total hip arthroplasty (THA) and total knee arthroplasty (TKA) performed during the same admission) versus bilateral THA, bilateral TKA, single THA, and single TKA. Combined TJAs performed on the same day were compared with those staged within the same admission episode. Patients and Methods Data from the National (Nationwide) Inpatient Sample recorded between 2005 and 2014 were used for this retrospective cohort study. Postoperative in-hospital complications, total costs, and discharge destination were reviewed. Logistic and linear regression were used to perform the statistical analyses. p-values less than 0.05 were considered statistically significant. Results Combined TJA was associated with increased risk of deep vein thrombosis, prosthetic joint infection, irrigation and debridement procedures, revision arthroplasty, length of stay (LOS), and in-hospital costs compared with bilateral THA, bilateral TKA, single THA, and single TKA. Combined TJA performed on separate days of the same admission showed no statistically significant differences when compared with same-day combined TJA, but trended towards decreased total costs and total complications despite increased LOS. Conclusion Combined TJA is associated with increased in-hospital complications, LOS, and costs. We do not recommend performing combined TJA during the same hospital stay. Cite this article: Bone Joint J 2019;101-B:573–581.

Predictors of Successful Early Discharge for Total Hip and Knee Arthroplasty in Octogenarians

2021 ◽  
pp. 155633162110306
Author(s):  
Andrew B. Kay ◽  
Danielle Y. Ponzio ◽  
Courtney D. Bell ◽  
Fabio Orozco ◽  
Zachary D. Post ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Early Discharge ◽  
Readmission Rates ◽  
Patients Âgés ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Student’S T ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Decreased length of stay after total joint arthroplasty (TJA) is becoming a more common way to contain healthcare costs and increase patient satisfaction. There is little evidence to support “early” discharge in elderly patients. Purpose: We sought to identify preoperative factors that correlated with early discharge (by postoperative day [POD] 1) in comparison to late discharge (after POD2) in octogenarians after TJA. Methods: In a retrospective cohort study from a single institution, we identified 482 patients ages 80 to 89 who underwent primary TJA from January 2014 to December 2017; 319 had total knee arthroplasty (TKA) and 163 had total hip arthroplasty (THA). Data collected included preoperative knee range of motion (ROM), demographics, and comorbidities; 90-day readmission and mortality rates were also evaluated. P values for continuous data were calculated using student’s t test and for categorical data using χ2 testing. Results: Of octogenarian patients, 30.9% were discharged by POD1. Early discharge was associated with being male, married, and nonsmoking, as well as having an American Society of Anesthesiologists (ASA) score of 2, independent preoperative ambulation, and a postoperative caregiver. Type of procedure (TKA vs THA), body mass index, laterality, preoperative range of motion (ROM) for TKA, and single vs multilevel home did not affect the probability of early discharge. Discharge on POD1 was not associated with increased 90-day readmission rates. There were no deaths. Conclusion: Early discharge for octogenarians can be successfully implemented in a select subset of patients without increasing 90-day readmission or death rates. There are multiple factors that predict successful early discharge.

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