scholarly journals Does Prophylactic Administration of Edoxaban Increase D-Dimer Levels after Total Hip Arthroplasty?

2019 ◽  
Vol 8 (5) ◽  
pp. 678 ◽  
Author(s):  
Toshiyuki Kawai ◽  
Yutaka Kuroda ◽  
Koji Goto ◽  
Shuichi Matsuda
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Regression Analyses ◽  
Independent Variables ◽  
Total Hip ◽  
Clinically Important Difference ◽  
Duration Of Surgery ◽  
D Dimer

This study aimed to examine the effect of thromboprophylactic edoxaban on D-dimer levels and anemia after total hip arthroplasty (THA). We retrospectively analyzed data from 349 patients undergoing primary THA. Univariate regression and multivariate regression analyses were performed with D-dimer levels on the 7th, 14th, and 21st days postoperatively as the dependent variable Edoxaban use, age, sex, body mass index (BMI), renal function, drop in hemoglobin (Hb) drop, intraoperative blood loss and duration of surgery as were independent variables. Multivariate regression analysis was also performed with Hb drop as the dependent variable. Edoxaban administration of 15 mg/day and 30 mg/day after THA was correlated with higher D-dimer levels at 21, but not at 7 or 14, days postoperatively. Other significant independent predictors for high D-dimer levels were the duration of surgery (at 7 and 14 days), BMI (at 7 days), sex (at 14 days), and age (at 14 and 21 days). Edoxaban use was significantly, weakly correlated with a larger Hb drop at 7 and 14 days, but this was less than a clinically important difference. D-dimer levels after THA can be elevated by thromboprophylactic edoxaban after three weeks postoperatively.

scholarly journals Total Hip Arthroplasty: Minimal Clinically Important Difference and Patient Acceptable Symptom State for the Forgotten Joint Score 12

2021 ◽  
Vol 18 (5) ◽  
pp. 2267
Author(s):  
Umile Giuseppe Longo ◽  
Sergio De Salvatore ◽  
Ilaria Piergentili ◽  
Anna Indiveri ◽  
Calogero Di Naro ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Validity And Reliability ◽  
Total Hip ◽  
Forgotten Joint Score ◽  
Post Surgery ◽  
Clinically Important Difference ◽  
Patient Reported ◽  
Patient Acceptable Symptom State

The Forgotten Joint Score-12 (FJS-12) is a valid patient-reported outcome measures (PROMs) used to assess prosthesis awareness during daily activities after total hip arthroplasty (THA). The minimum clinically important difference (MCID) can be defined as the smallest change or difference that is evaluated as beneficial and could change the patient’s clinical management. The patient acceptable symptom state (PASS) is considered the minimum PROMs cut-off value that corresponds to a patient’s satisfactory state of health. Despite the validity and reliability of the FJS-12 having been already demonstrated, the MCID and the PASS of this score have not previously been defined. Patients undergoing THA from January 2019 to October 2019 were assessed pre-operatively and six months post-surgery using the FJS-12, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford Hip Score (OHS). Pre-operative and follow-up questionnaires were completed by 50 patients. Both distribution-based approaches and anchor approaches were used to estimate MCID. The aim of this paper was to assess the MCID and PASS values of FJS-12 after total hip replacement. The FJS-12 MCID from baseline to 6 months post-operative follow-up was 17.5. The PASS calculated ranged from 69.8 to 91.7.

Comorbidities and indications for total hip arthroplasty at a tertiary care center in Saudi Arabia

2021 ◽  
Vol 12 (3) ◽  
pp. 59-63
Author(s):  
Bandar M Hetaimish ◽  
Eyad A Alakkas ◽  
Khalid F Alharbi ◽  
Abdulrahman M Alradadi ◽  
Habib Y Aletani ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Chronic Diseases ◽  
Hip Arthroplasty ◽  
Common Indication ◽  
Total Hip ◽  
Tertiary Center ◽  
Duration Of Surgery ◽  
Post Traumatic

Objectives: Total hip arthroplasty (THA) is one of the most effective orthopedic interventions for the treatment of patients with advanced‑ stage hip disease. However, reports regarding indications for primary THA in Saudi Arabia are limited. We aimed to evaluate primary indications for THA and identify associated chronic diseases and postoperative complications in THA patients at a tertiary hospital in Saudi Arabia. These are important to provide knowledge on types of hip diseases and variables that may affect the outcome of this intervention in the Saudi population. Methods: This is a retrospective cohort study of THA cases performed between 2010 and 2019 at a tertiary center in Saudi Arabia. Retrieved data include patients’ ages at the time of surgery, chronic diseases, presurgical diagnosis, site and duration of surgery, and postoperative complications. Results: We identified 83 patients who had undergone primary THA; in regard to comorbidities, 32.5% and 30.1% had hypertension and diabetes mellitus, respectively. The most common indication for THA was degenerative hip osteoarthritis (50.6%), followed by post-traumatic arthritis (22.9%) and hip avascular necrosis (20.5%). Conclusion: Despite the high rate of trauma and accidents in Saudi Arabia, degenerative osteoarthritis remains the most common indication for primary THA. Post-traumatic osteoarthritis is identified as the second major indication for THA.

Duration of surgery affects the risk of complications following total hip arthroplasty

2019 ◽  
Vol 101-B (6_Supple_B) ◽  
pp. 51-56
Author(s):  
L. L. Nowak ◽  
E. H. Schemitsch
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Operating Time ◽  
Improvement Program ◽  
Surgical Quality ◽  
Total Hip ◽  
Major Complications ◽  
Duration Of Surgery ◽  
American College Of Surgeons ◽  
Multivariable Regression

Aims The aim of this study was to assess the influence of operating time on 30-day complications following total hip arthroplasty (THA). Patients and Methods We identified patients aged 18 years and older who underwent THA between 2006 and 2016 from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. We identified 131 361 patients, with a mean age of 65 years (sd 12), who underwent THA. We used multivariable regression to determine if the rate of complications and re-admissions was related to the operating time, while adjusting for relevant covariables. Results The mean operating time decreased from 118.3 minutes (29.0 to 217.0) in 2006, to 89.6 minutes (20.0 to 240.0) in 2016. After adjustment for covariables, operating times of between 90 and 119 minutes increased the risk of minor complications by 1.2 (95% confidence interval (CI) 1.1 to 1.3), while operating times of between 120 and 179 minutes increased the risk of major complications by 1.4 (95% CI 1.3 to 1.6) and minor complications by 1.4 (95% CI 1.2 to 1.5), and operating times of 180 minutes or more increased the risk of major complications by 2.1 (95% CI 1.8 to 2.6) and minor complications by 1.9 (95% CI 1.6 to 2.3). There was no difference in the overall risk of complications for operating times of between 20 and 39, 40 and 59, or 60 and 89 minutes (p > 0.05). Operating times of between 40 and 59 minutes decreased the risk of re-admission by 0.88 (95% CI 0.79 to 0.97), while operating times of between 120 and 179 minutes, and of 180 minutes or more, increased the risk of re-admission by 1.2 (95% CI 1.1 to 1.3) and 1.6 (95% CI 1.3 to 1.8), respectively. Conclusion These findings suggest that an operating time of more than 90 minutes may be an independent predictor of major and minor complications, as well as re-admission, following THA, and that an operating time of between 40 and 90 minutes may be ideal. Prospective studies are required to confirm these findings. Cite this article: Bone Joint J 2019;101-B(6 Supple B):51–56.

Deep vein thrombosis after total hip arthroplasty in Korean patients and D-dimer as a screening tool

2008 ◽  
Vol 129 (7) ◽  
pp. 887-894 ◽  
Author(s):  
Myung-Chul Yoo ◽  
Yoon-Je Cho ◽  
Elie Ghanem ◽  
Alankar Ramteke ◽  
Kang-Il Kim
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Screening Tool ◽  
Total Hip ◽  
Korean Patients ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
D Dimer

Changes of D-dimer after total hip arthroplasty in patients with and without intraoperative heparin

2007 ◽  
Vol 128 (1) ◽  
pp. 37-40 ◽  
Author(s):  
Katsuhiko Maezawa ◽  
Masahiko Nozawa ◽  
Kentaro Aritomi ◽  
Mitsuaki Kubota ◽  
Katsuo Shitoto ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
D Dimer

scholarly journals Preoperative Factors Predicting the Severity of BMD Loss Around the Implant after Total Hip Arthroplasty

2021 ◽  
Author(s):  
Akira Morita ◽  
Kobayashi Naomi ◽  
Hyonmin Choe ◽  
Taro Tezuka ◽  
Shota Higashihira ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Multivariate Regression ◽  
Harris Hip Score ◽  
Lateral Side ◽  
Mineral Density ◽  
Factors Associated ◽  
Total Hip ◽  
Preoperative Factors

Abstract BackgroundStress shielding after total hip arthroplasty (THA) leads to the loss of bone mineral density (BMD) around the femoral implants, particularly in the proximal area. BMD loss around the implant is likely to occur within 1 year after THA, but its severity depends on patient characteristics. This study evaluated preoperative factors associated with the severity of zone 7 BMD loss after THA.MethodsThis retrospective cohort study included 48 patients who underwent primary THA at our hospital from October 2011 to December 2015. All patients underwent implantation of a Zweymüller-type femoral component without any postoperative osteoporosis medications. The objective variable was change in zone 7 BMD after 1 year. Factors evaluated included age, body mass index (BMI), Japanese Orthopaedic Association (JOA) score, Harris Hip Score (HHS), Canal Flare Index (CFI), and lumbar BMD on the frontal and lateral sides. Factors associated with loss of zone 7 BMD were identified by univariate and multivariate regression analyses.ResultsUnivariate regression analysis showed that CFI (P=0.003) and preoperative lumbar BMD on the frontal (P=0.003) and lateral (P<0.001) sides were significantly correlated with loss of zone 7 BMD. Multivariate regression analysis showed that CFI (P=0.014) and lumbar BMD on the lateral side (P<0.001) were independently correlated with loss of zone 7 BMD.ConclusionLower preoperative lumbar BMD on the lateral side and lower CFI were significantly associated with zone 7 BMD loss after THA. Patients with these characteristics should be carefully monitored for severe BMD loss after THA.

scholarly journals Usefulness of a novel method for the screening of deep vein thrombosis by using a combined D-dimer- and age-based index before total hip arthroplasty

PLoS ONE ◽  
2017 ◽  
Vol 12 (2) ◽  
pp. e0172849 ◽  
Author(s):  
Norio Imai ◽  
Dai Miyasaka ◽  
Hayato Shimada ◽  
Ken Suda ◽  
Tomoyuki Ito ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Novel Method ◽  
Deep Vein ◽  
D Dimer

scholarly journals Preoperative factors predicting the severity of BMD loss around the implant after Total hip Arthroplasty

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Akira Morita ◽  
Naomi Kobayashi ◽  
Hyonmin Choe ◽  
Taro Tezuka ◽  
Shota Higashihira ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Multivariate Regression ◽  
Japanese Orthopaedic Association ◽  
Harris Hip Score ◽  
Lateral Side ◽  
Mineral Density ◽  
Total Hip ◽  
Preoperative Factors

Abstract Background Stress shielding after total hip arthroplasty (THA) leads to loss of bone mineral density (BMD) around the femoral implants, particularly in the proximal area. Loss of BMD around the implant is likely to occur within 1 year after THA; however, its severity depends on patient characteristics. This study evaluated preoperative factors correlated with the severity of zone 7 BMD loss after THA. Methods This retrospective cohort study included 48 patients who underwent primary THA from October 2011 to December 2015. All patients underwent implantation of a Zweymüller-type femoral component without any postoperative osteoporosis medications. The objective variable was a change in zone 7 BMD after 1 year. Factors evaluated included age, body mass index, Japanese Orthopaedic Association score, Harris Hip Score, Canal Flare Index (CFI), and lumbar BMD on the frontal and lateral sides. Univariate and multivariate regression analyses identified factors correlated with loss of zone 7 BMD. Results Univariate regression analysis identified CFI (P = 0.003) and preoperative lumbar BMD on the anterior-posterior (P = 0.003) and lateral (P < 0.001) sides as being correlated with loss of zone 7 BMD. Multivariate regression analysis identified CFI (P = 0.014) and lumbar BMD on the lateral side (P < 0.001) as being correlated independently with loss of zone 7 BMD. Conclusion Lower preoperative lumbar BMD on the lateral side and lower CFI were correlated with zone 7 BMD loss after THA. Patients with these characteristics should be monitored carefully for severe BMD loss after THA.

scholarly journals Surgical technique of total hip arthroplasty: an experience from a tertiary level hospital in India

2018 ◽  
Vol 4 (5) ◽  
pp. 763
Author(s):  
Lokesh Gupta ◽  
Mukund Lal ◽  
Vineet Aggarwal ◽  
Lakshya Prateek Rathor
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Anatomical Variations ◽  
Medullary Canal ◽  
Posterolateral Approach ◽  
Harris Hip Score ◽  
Hip Joints ◽  
Total Hip ◽  
Duration Of Surgery ◽  
Gandhi Medical College

<p class="abstract"><strong>Background:</strong> Total hip arthroplasty (THA) is performed for patients with hip pain, which may arise due to a variety of conditions.</p><p class="abstract"><strong>Methods:</strong> An observational study of 20 hip joints presenting to the Department of Orthopedic Surgery, Indira Gandhi Medical College Shimla from December 2008 till December 2010 for THR was done. Laboratory and imaging investigations were performed as per the standard operating protocol of our center. Modified Harris Hip scoring was done for all included patients pre-operatively. A posterolateral approach with posterior dislocation of hip was used in all the patients. Pre-operative and intra-operative details were noted using a pretested semi-structured questionnaire. Data were analysed descriptively and tabulated to draw conclusions.<strong></strong></p><p class="abstract"><strong>Results:</strong> Both sides were operated with equal frequency, while one patient had a bilateral THA. Most common indication of surgery was osteoarthritis secondary to avascular necrosis head of femur (n=16). Pre-operative modified Harris hip score was poor in all 20 hip joints. Duration of surgery ranged from 110 minutes to 190 minutes, mean duration being 139 minutes. Average blood loss during the surgical procedures was about 532 ml with average drainage of about 230 ml. On an average medullary canal flare index of 3.97 was for all the patients. Morphological cortical index averaged at 3.11 and Dorr index at 3.54.</p><p class="abstract"><strong>Conclusions:</strong> Most systems for THA are modular which provide flexibility in dealing with intraoperative anatomical variations. Different types of femoral and acetabular implants are available for use which reflect the different philosophies regarding the techniques involved in THA. Further studies are required to support our findings.</p>

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