Preoperative erythrocyte sedimentation rate in patients with rheumatoid arthritis predicts deep vein thrombosis following total knee arthroplasty

2021 ◽  
pp. 1-9
Author(s):  
Pu Ying ◽  
Tong Lu ◽  
Yue Xu ◽  
Yiming Miu ◽  
Yi Xue ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Erythrocyte Sedimentation Rate ◽  
Knee Arthroplasty ◽  
Sedimentation Rate ◽  
Roc Curve Analysis ◽  
Vein Thrombosis ◽  
Erythrocyte Sedimentation ◽  
History Of ◽  
Total Knee

PURPOSE: To thoroughly evaluate preoperative risk factors for deep venous thrombosis (DVT) in patients with knee rheumatoid arthritis (RA) undergoing unilateral total knee arthroplasty (TKA). METHODS: Clinical data of 106 patients with knee RA who underwent unilateral TKA from August 2014 to October 2020 were collected. All patients received ultrasonic examination of the veins of both lower extremities on the third day after TKA and were divided into DVT and non-DVT groups. The associations between age, gender, body mass index (BMI), history of diabetes/hypertension, common serum lipid levels, indicators related to coagulation function, blood viscosity, erythrocyte sedimentation rate (ESR) and postoperative DVT were statistically compared and analyzed. RESULTS: ESR was significantly correlated with DVT risk after TKA (OR = 1.844, 95% CI = 1.022–2.981, P = 0.019). Receiver operating characteristic (ROC) curve analysis showed the optimal cut-off point of ESR for predicting DVT was 42 mm/h with a sensitivity of 95.5% and specificity of 66.7% . CONCLUSION: An increased preoperative ESR value is a risk factor for DVT in patients with knee RA following unilateral TKA. Pre-surgery control of ESR level and prevention of postoperative DVT in these patients are worthy of attention.

Risk of Venous Thromboembolism after Total Knee Arthroplasty in Patients with Rheumatoid Arthritis

2015 ◽  
Vol 42 (6) ◽  
pp. 928-934 ◽  
Author(s):  
Masahiro Izumi ◽  
Kiyoshi Migita ◽  
Mashio Nakamura ◽  
Yuka Jiuchi ◽  
Tatsuya Sakai ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Venous Thromboembolism ◽  
Knee Arthroplasty ◽  
Demographic Data ◽  
Japanese Patients ◽  
Study Cohort ◽  
Vein Thrombosis ◽  
Total Knee ◽  
D Dimer

Objective.To compare the incidence of venous thromboembolism (VTE) following total knee arthroplasty (TKA) between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA).Methods.The subjects were composed of 1084 Japanese patients with OA and 204 with RA. Primary effectiveness outcomes were any deep vein thrombosis (DVT) as detected by bilateral ultrasonography up to postoperative Day 10 (POD10) and pulmonary embolism (PE) up to POD28. The main safety outcomes were bleeding and death from any cause up to POD28. Plasma D-dimer levels were measured before and at POD10 after TKA.Results.The study cohort was composed of 1288 patients from 34 hospitals. There was no death up to POD28. PE occurred in 2 patients with OA and in no patients with RA. The incidence of primary effectiveness outcome was 24.3% and 24.0% in patients with OA and RA, respectively. The incidence of major bleeding up to POD28 was 1.3% and 0.5% in patients with OA and RA, respectively. No differences in the incidence of VTE (symptomatic/asymptomatic DVT plus PE) or bleeding were noted between patients with RA and OA. D-dimer levels on POD10 were significantly higher in patients with OA compared with those with RA. Also, D-dimer levels on POD10 were significantly lower in patients receiving fondaparinux than in patients without pharmacological prophylaxis.Conclusion.Despite some differences in demographic data, patients with RA and OA have equivalent risks of VTE and bleeding following TKA.

scholarly journals Severe heterotopic ossification post total knee arthroplasty in a patient with rheumatoid arthritis: a case report

2020 ◽  
Vol 2020 (3) ◽  
Author(s):  
Abdullah A Alturki ◽  
Sarah A Aldeghaither ◽  
Ali A Alhandi
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Heterotopic Ossification ◽  
Knee Arthroplasty ◽  
Bone Cells ◽  
Restricted Range ◽  
Skeletal Tissue ◽  
History Of ◽  
Total Knee ◽  
Revision Tka

Abstract Stiffness following total knee arthroplasty (TKA) can be a devastating complication to the patient by limiting his function. Various causes have been reported in the literature, including heterotopic ossification (HO). HO is one of the rarely reported complication of TKA characterized by deposition of bone cells in non-skeletal tissue. This is a case of 32-year-old female known to have rheumatoid arthritis with history of TKA 4-years-ago complaining of right knee pain and restricted range of motion. She was later found to have HO and was treated with a revision TKA. In conclusion, the incidence and outcome of HO following total knee replacement in patients with RA remains underexplored topic in the literature.

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.

scholarly journals Current review of surgical management options for total knee arthroplasty in the rheumatoid knee

2021 ◽  
Vol 4 (1) ◽  
pp. 38-45
Author(s):  
Sergiu Andrei Iordache ◽  
Bogdan Şerban ◽  
Mihnea Ioan Gabriel Popa ◽  
Adrian Cursaru
Keyword(s):  
Rheumatoid Arthritis ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Operating Time ◽  
Joint Damage ◽  
Management Options ◽  
Therapeutic Modalities ◽  
Vein Thrombosis ◽  
Joint Deformity ◽  
Total Knee

Abstract Rheumatoid arthritis (RA) represents a condition that can erode cartilage and damage joints, leading to inflammation and loss of movement, characterized by inflammatory synovitis. While the widespread use of potent disease-modifying medications has increased opportunities for RA patients, orthopedic surgery and complete joint arthroplasty remain an important option in end-stage joint treatment. The knee is one of the most frequently affected joints in chronic rheumatoid arthritis patients. The severity of RA ranges from a moderate illness to a serious, rapidly progressing, destructive version, gradually leading to incessant pain and joint deformity. Despite recent advances in biological agents and therapeutic modalities in the field of rheumatology, certain patients with RA, who ultimately undergo joint surgery, tend to experience progressive joint damage. Though, TKA can be performed in these patients, increased complications and poorer outcomes may result after total knee arthroplasty, because of the particularities given by RA. They are associated with extended operating time, specifically resulting in increased infection, blood loss and deep vein thrombosis. However, because RA patients present additional risk factors for complications, certain critical preoperative examination and surgical aspects need to be considered in order to maximize TKA outcomes in this subgroup of patients.

scholarly journals Effect of Celecoxib on Surgical Site Inflammation after Total Knee Arthroplasty: A Randomized Controlled Study

2018 ◽  
Vol 27 (5) ◽  
pp. 481-488
Author(s):  
Xun Xu ◽  
Weilin Sang ◽  
Yu Liu ◽  
Libo Zhu ◽  
Haiming Lu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Sedimentation Rate ◽  
Control Group ◽  
C Reactive Protein ◽  
Tramadol Hydrochloride ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Total Knee ◽  
Experimental Group

Objective: To evaluate the anti-inflammatory effectiveness of celecoxib and its effect on the rehabilitation of joint function after total knee arthroplasty. Methods: 72 patients presented between 2016 and 2017 and were divided into two groups. The experimental group was given 200 mg celecoxib twice daily with tramadol hydrochloride 50 mg twice daily (as required); the control group was given tramadol hydrochloride 50 mg twice daily for 6 weeks from the first day after total knee arthroplasty. Skin temperature around the knee was measured 1 day before surgery, on postoperative days 1 and 3, and at weeks 1, 2, and 6. Inflammatory markers (white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and interleukin-6) were measured preoperatively, on postoperative day 3, and at weeks 1 and 6. Knee Society Score was recorded preoperatively and at postoperative weeks 1, 2, and 6. Results: Except for preoperative skin temperature, the recorded skin temperatures of the experimental group were significantly different compared to those of the control group (p = 0.001, 0.024, 0.030, 0.041, 0.047, respectively). Levels of C-reactive protein were significantly different at the 1st and the 6th week after surgery, differing by 19.3 ± 4.64 mg/L (p < 0.001) and 2.6 ± 0.92 mg/L (p = 0.006). Levels of interleukin-6 showed a significant difference of 6.61 ± 2.36 pg/mL (p = 0.007) at the 1st week after surgery. Until the 6th week after surgery, the erythrocyte sedimentation rate in the experimental group and the control group differed by 17 ± 4.6 mm/h (p = 0.001). Conclusions: Celecoxib has a significant inhibitory effect on postoperative aseptic inflammation.

Sign in / Sign up

Export Citation Format

Share Document