scholarly journals No difference in the incidence or location of deep venous thrombosis according to use of pharmacological prophylaxis following total knee arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Junya Itou ◽  
Umito Kuwashima ◽  
Masafumi Itoh ◽  
Ken Okazaki
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Duplex Ultrasound ◽  
Bleeding Risk ◽  
Vein Wall ◽  
Pharmacological Prophylaxis ◽  
Vein Thrombosis ◽  
Pharmacologic Prophylaxis ◽  
Total Knee ◽  
The Difference

Abstract Background The incidence and characteristics of deep vein thrombosis (DVT) following total knee arthroplasty (TKA) without pharmacologic prophylaxis have not been fully investigated. This study aimed to determine whether there are any differences in the incidence, location, and characteristics of DVT following TKA with pharmacologic prophylaxis and without pharmacologic prophylaxis. Methods A total of 156 knees were retrospectively evaluated for DVT following TKA by duplex ultrasound on postoperative day 7, after excluding 60 knees from 216 consecutive knees because of antiplatelet or anticoagulant use before surgery, history of venous thromboembolism, or bleeding risk. The 156 knees included in the analysis were divided into two groups: with pharmacologic prophylaxis (n = 79) and without pharmacologic prophylaxis (n = 77). Results The overall incidence of DVT was 34% (54/156 knees). DVT was detected in 31.6% of knees with pharmacologic prophylaxis and in 37.6% of knees without pharmacologic prophylaxis; the difference was not statistically significant. Soleal vein thrombus was observed in 74.6% of the knees with DVT and non-floating thrombus was observed in 98.7%. There were no obvious between-group differences in thrombus characteristics such as compressibility, echogenicity, mean vein diameter, and whether the thrombus was attached to the vein wall or free-floating. Conclusions No differences were found in the incidence, location, or characteristics of DVT following TKA with or without pharmacological prophylaxis.

scholarly journals No Difference In The Incidence Or Location of Deep Venous Thrombosis According To Use of Pharmacological Prophylaxis Following Total Knee Arthroplasty

2021 ◽  
Author(s):  
Junya Itou ◽  
Umito Kuwashima ◽  
Masafumi Itoh ◽  
Ken Okazaki
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Antiplatelet Agents ◽  
Bleeding Risk ◽  
Pharmacological Prophylaxis ◽  
Vein Thrombosis ◽  
Pharmacologic Prophylaxis ◽  
History Of ◽  
Total Knee ◽  
The Difference

Abstract Purpose: The incidence and characteristics of deep vein thrombosis (DVT) following total knee arthroplasty (TKA) without pharmacologic prophylaxis have not been fully investigated. This study aimed to determine whether there are any differences in the incidence, location, and characteristics of DVT following TKA with pharmacologic prophylaxis and without pharmacologic prophylaxis.Methods: In total, 216 consecutive knees that underwent primary TKA were retrospectively evaluated. Enoxaparin was used postoperatively for pharmacologic prophylaxis. We excluded 60 knees because of use of antiplatelet agents or anticoagulants before surgery, history of venous thromboembolism, or bleeding risk. The remaining 156 knees were included in the analysis and divided into two groups: with pharmacologic prophylaxis (n = 79) and without pharmacologic prophylaxis (n = 77).Results: The overall incidence of DVT was 34% (54/156 knees). DVT was detected in 31.6% of knees in the group with pharmacologic prophylaxis and in 37.6% of knees in the group without pharmacologic prophylaxis; the difference was not statistically significant. Soleal vein thrombus was observed in 74.6% of the knees with DVT and non-floating thrombus was observed in 98.7%.Conclusion: No differences were found in the incidence, location, or characteristics of DVT following TKA with or without pharmacological prophylaxis.

Increased Prevalence, Complications, and Costs of Smokers Undergoing Total Knee Arthroplasty

2020 ◽  
Author(s):  
Sean S. Rajaee ◽  
Eytan M. Debbi ◽  
Guy D. Paiement ◽  
Andrew I. Spitzer
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Smoking Status ◽  
Hospital Costs ◽  
Patient Characteristics ◽  
The United States ◽  
Bundled Payment ◽  
Vein Thrombosis ◽  
Total Knee ◽  
Payment Models

AbstractGiven a national push toward bundled payment models, the purpose of this study was to examine the prevalence as well as the effect of smoking on early inpatient complications and cost following elective total knee arthroplasty (TKA) in the United States across multiple years. Using the nationwide inpatient sample, all primary elective TKA admissions were identified from 2012 to 2014. Patients were stratified by smoking status through a secondary diagnosis of “tobacco use disorder.” Patient characteristics as well as prevalence, costs, and incidence of complications were compared. There was a significant increase in the rate of smoking in TKA from 17.9% in 2012 to 19.2% in 2014 (p < 0.0001). The highest rate was seen in patients < 45 years of age (27.3%). Hospital resource usage was significantly higher for smokers, with a length of stay of 3.3 versus 2.9 days (p < 0.0001), and hospital costs of $16,752 versus $15,653 (p < 0.0001). A multivariable logistic model adjusting for age, gender, and comorbidities showed that smokers had an increased odds ratio for myocardial infarction (5.72), cardiac arrest (4.59), stroke (4.42), inpatient mortality (4.21), pneumonia (4.01), acute renal failure (2.95), deep vein thrombosis (2.74), urinary tract infection (2.43), transfusion (1.38) and sepsis (0.65) (all p < 0.0001). Smoking is common among patients undergoing elective TKA, and its prevalence continues to rise. Smoking is associated with higher hospital costs as well as higher rates of immediate inpatient complications. These findings are critical for risk stratification, improving of bundled payment models as well as patient education, and optimization prior to surgery to reduce costs and complications.

scholarly journals Topical vs. intravenous administration of tranexamic acid in knee arthroplasty and prevalence of deep venous thrombosis: a randomized clinical trial

2016 ◽  
Vol 15 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Ari Zekcer ◽  
Ricardo Del Priori ◽  
Clauber Tieppo ◽  
Ricardo Soares da Silva ◽  
Nilson Roberto Severino
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Intravenous Administration ◽  
Knee Arthroplasty ◽  
Duplex Ultrasound ◽  
Control Group ◽  
Perioperative Bleeding ◽  
Total Knee

Abstract Background Tranexamic acid (TXA) is widely used in orthopedic surgery to reduce perioperative bleeding. Since TXA inhibits fibrinolysis, there is concern that it may increase the risk of thromboembolic events. Objectives To verify the prevalence of deep venous thrombosis (DVT) in patients receiving TXA during total knee arthroplasty and to compare topical with intravenous administration of the drug. Methods All patients admitted for total knee arthroplasty due to primary arthrosis between June and November of 2014 were recruited consecutively. Thirty patients were randomized to a “topical group” (1.5 g TXA diluted in 50ml saline sprayed over the area operated, before tourniquet release), 30 to an “intravenous group” (20mg/kg TXA in 100 ml of saline, given at the same time as anesthesia), and 30 to a control group (100 ml of saline, given at the same time as anesthesia). All patients had duplex ultrasound scans of the legs on the 15th postoperative day. Results Deep venous thrombosis events occurred in five of the 90 patients operated (one out of 30 in the topical group [3.3%], four out of 30 in the control group [13.3%], and zero in the intravenous group). All were confirmed by duplex ultrasound scans and all were asymptomatic. Prevalence rates of DVT were similar between groups (p = 0.112 for control vs. intravenous; p = 0.353 for control vs. topical; and p =1.000 for intravenous vs. topical, according to two-sided exact tests). Conclusions Both topical and intravenous administration of TXA are safe with regard to occurrence of DVT, since the number of DVT cases in patients given TXA was not different to the number in those given placebo.

scholarly journals Osteoarthritis of the knee joint. Etiology, treatment, rehabilitation (analytical review of the literature)

TRAUMA ◽  
2021 ◽  
Vol 22 (3) ◽  
pp. 5-11
Author(s):  
Khaled Obeidat ◽  
O.D. Karpinska
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Joint ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Gait Parameters ◽  
Total Knee ◽  
The Difference ◽  
Knee Pathology

According to epidemiological studies, osteoarthritis accounts for 10–12 % of all cases of musculoskeletal diseases. In the general structure of knee pathology, degenerative diseases make up 57.8 %. The urgency of the problems of gonarthrosis is due to not only its widespread prevalence, but also the high risk of developing knee dysfunction, accompanied by a significant reduction in the quality of life of patients and often leading to partial or permanent disability of patients. Gonarthrosis has significant gender features. Women account for about 70 % of the number of patients, while men had this disease almost 2 times less often, but other data indicate that the incidence of gonarthrosis in men under 60 years of age is higher, and in women it begins to increase after 65 years. Knee replacement is a leading method in the treatment of knee osteoarthritis stages III–IV. The tendency towards an increase in the total number of surgeries leads to an increase in the frequency of complications and unsatisfactory results: according to some authors, from 3.3 to 13.2 % of patients complain of knee replacement outcomes. Studies of long-term complaints after arthroplasty have shown that in addition to pain reduction, some patients had an increase in varus angle when bending the knee while walking but they didn’t mark an improvement in gait parameters compared to preoperative examination. After unilateral total knee arthroplasty, the load patterns of the frontal plane in the operated knee remain pathological in the long run. After knee arthroplasty, there is muscle weakness, and studies have shown changes in all muscles of the lower extremity. Weakening of some muscles led to compensatory strengthening of others. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low efficiency. Many studies have studied motor activity of patients after total knee arthroplasty in recent years. Not only gait features, but also movements of the pelvis, trunk and upper extremities are studied. Modern methods of diagnosing spatial oscillations of the body when walking have shown that disorders of body movements — excessive hand movements, pelvic loosening, asymmetrical flexion of the knee joints, etc., after arthroplasty are preserved in patients and restore slowly, and some disorders remain forever. Conclusions. Knee arthroplasty relieves pain, improves quality of life, but according to many authors, patients complain of incomplete restoration of the functionality of the prosthetic limb. According to the researchers, the main cause for incomplete reco-very of gait parameters is the difference in the frontal angles of the knee joint flexion and the difference in the length of the steps. Special training exercises can reduce the asymmetry of the steps, but it is difficult to completely restore the symmetry of the steps within 2 years. Studies of the effect of preoperative rehabilitation on the outcome of knee arthroplasty have shown its low effectiveness.

scholarly journals Comparison of Short-Term Efficacy of Total Knee Arthroplasty Versus Arthroscopy in Chinese Patients with Knee Osteoarthritis

2020 ◽  
Author(s):  
Xiaolin Jia ◽  
San Cai ◽  
Wei Hu ◽  
Qiang Gan ◽  
Mingquan Zhou
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Scientific Basis ◽  
Knee Function ◽  
Chinese Patients ◽  
Control Group ◽  
Total Knee ◽  
The Difference ◽  
Experimental Group

Abstract Background: The purpose of this study was to compare the improvement of knee function in patients with knee osteoarthritis who underwent total knee arthroplasty and arthroscopy in China, and to provide a scientific basis for the application of clinical total knee arthroplasty in knee osteoarthritis.Methods: A total of 160 patients with knee osteoarthritis who were admitted to Chinese hospital from January 2017 to December 2018 were studied. They were divided into experimental group and control group according to their willingness of treatment. The control group was treated with arthroscopy and the experimental group was treated with total knee arthroplasty. All patients were followed for a period of 6 months. The knee joint function score (HSS), visual analog scale (VAS), and anxiety self-assessment scale (SAS) scores before and after surgery were compared between the two groups. Results: The proportion of "excellent or good" in the efficacy of the experimental group (91.25%) was higher than that of the control group (72.50%), and the difference was statistically significant (χ2=9.476, P<0.05). The HSS score of the experimental group was higher than that of the control group (P<0.05), while the VAS and SAS scores were lower than those of the control group (P<0.05). The scores of various SF-36 scales in the experimental group were higher than those in the control group after operation (P<0.05).Conclusions: Total knee arthroplasty was considered effective in treating patients with knee osteoarthritis that meet the indications, and is beneficial to improve knee function and reduce pain in patients. The surgical treatment also reduced the level of anxiety and effectively improve the quality of life of patients. Further investigation of its clinical application on treatment of knee osteoarthritis is warranted.

Less deep vein thrombosis due to transcutaneous fibular nerve stimulation in total knee arthroplasty: a randomized controlled trial

2014 ◽  
Vol 23 (11) ◽  
pp. 3317-3323 ◽  
Author(s):  
Masashi Izumi ◽  
Masahiko Ikeuchi ◽  
Koji Aso ◽  
Natsuki Sugimura ◽  
Yuko Kamimoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Deep Vein Thrombosis ◽  
Knee Arthroplasty ◽  
Controlled Trial ◽  
Vein Thrombosis ◽  
Randomized Controlled ◽  
Total Knee ◽  
Deep Vein ◽  
Fibular Nerve

A radiological analysis of the difference between MRI- and CT-based patient-specific matched guides for total knee arthroplasty from the same manufacturer

2016 ◽  
Vol 98-B (6) ◽  
pp. 786-792 ◽  
Author(s):  
M. G. M. Schotanus ◽  
R. Sollie ◽  
E. H. van Haaren ◽  
R. P. M. Hendrickx ◽  
E. J. P. Jansen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Total Knee ◽  
The Difference ◽  
Radiological Analysis

Prophylaxis of Deep Vein Thrombosis After Total Knee Arthroplasty

2001 ◽  
pp. 209-221
Author(s):  
Geoffrey H. Westrich ◽  
Steven B. Haas
Keyword(s):  
Total Knee Arthroplasty ◽  
Deep Vein Thrombosis ◽  
Knee Arthroplasty ◽  
Vein Thrombosis ◽  
Total Knee ◽  
Deep Vein

scholarly journals Effect of self-calf massage on the prevention of deep vein thrombosis after total knee arthroplasty: A randomized clinical trial

2020 ◽  
Vol 23 (1) ◽  
pp. 66-71
Author(s):  
Tomohiro OKA ◽  
Osamu WADA ◽  
Shingo NITTA ◽  
Hideto MARUNO ◽  
Kiyonori MIZUNO
Keyword(s):  
Clinical Trial ◽  
Total Knee Arthroplasty ◽  
Deep Vein Thrombosis ◽  
Randomized Clinical Trial ◽  
Knee Arthroplasty ◽  
Vein Thrombosis ◽  
Total Knee ◽  
Deep Vein
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