Inflammatory Biomarkers as Prognostic Factors of Acute Deep Vein Thrombosis Following the Total Knee Arthroplasty (original) (raw)
Related papers
2014
Background: Deep venous thrombosis (DVT), which is often associated with pulmonary embolism (PE), is a serious complication after total knee arthroplasty (TKA). In the present study, we examined the overall thrombotic and thrombolytic status using Global Thrombosis Test (GTT) in non-anticoagulated blood of patients undergoing TKA to develop the predictable marker for the incidence of DVT. Methods: DVT was diagnosed using doppler ultrasonography a day after the surgery in 31 patients with osteoarthritis (n = 24), rheumatoid arthritis (n = 6) and ankylosing spondylitis (n = 1) by the well-trained operator. We measured overall thrombotic and thrombolytic status using GTT and other biomarkers, which is associated with blood coagulation and fibrinolysis, before and immediately after the surgery. Results: Newly-generated DVT during the operation was detected in 11 of 31 patients (35.4%) 1 day after TKA. There were no differences in markers of coagulation (PT and APTT), platelet activity (platelet aggregation-induced by ADP and collagen) and fibrinolysis (FDP and D-dimer) between non-DVT and DVT group both before and after the surgery. Both Pre-and Post-operative GTT-occlusion times (OT), an index of platelet reactivity, were tended to be shorter, but not significant, in DVT group compared with non-DVT group. Pre-operative GTT-lysis time (LT), an index of thrombolytic activity, was significantly shorter in DVT group compared with non-DVT group, while there were no differences in post-operative value of this index between DVT group and non-DVT group, suggesting overall thrombolytic activity was enhanced in DVT group before surgery. Conclusions: Our data suggest that enhancement of pre-operative thrombolytic activity assessed by GTT may be a predictable marker for the incidence of DVT after TKA.
Zenodo (CERN European Organization for Nuclear Research), 2023
Knee replacement is one of the most commonly performed orthopedic surgeries today. Various prognostic markers are being investigated to reduce the revision rate. In this study, inflammatory markers measured from preoperative blood were evaluated in terms of revision. Material and Method: 100 patients who underwent Total Knee prosthesis between January 2017 and December 2021 (50 revisions and 50 non-revisions) were included in the study. Systemic immune-inflammatory index (SII), neutrophillymphocyte ratio(NLR), lymphocyte-monocyte ratio(LMR) and platelet-lymphocyte ratios(PLR) calculated from the hemograms taken before the first surgery of these patients; were evaluated comparatively between those with and without revision surgery. Results: The mean age of the patients was 63.98±9.30 (38-80) in patients who underwent revision, and 65.64±9.45 (46-87) in patients who did not undergo revision. There was no significant difference in age and gender distribution between the revised and non-revisioned groups (p>0.05). No significant difference was observed in the number of neutrophils, lymphocytes, and monocytes between the revised and non-revisioned groups (p>0.05). There was no significant difference in SII, NLR, LMR and PLR values between the revised and non-revisioned groups (p>0.05) Conclusion: SII, NLR, LMR and PLR calculated from the preoperative hemogram taken before total prosthesis surgery, and no significant relationship was found between revision of the knee prosthesis.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet, 2007
There have been sporadic reports on the Asian risk factor of DVT after total knee arthroplasty. To determine the risk factors of DVT MATERIAL AND METHOD: Retrospective review of one hundred patients who had undergone TKA and postoperative Contrast Venography in bilateral legs between 2002 and 2005 were performed to identify risk factor of DVT The patients were divided into two groups, positive and negative venography which the patients who had positive venography were indicating the development to DVT RESULTS: One hundred patients were evaluated associated to DVT Eighteen of these patients were men, and eighty-two were women. The median age at the time of the procedure was seventy-five years old (range: 62 - 79 years old). Sixty-one patients showed positive venography for D VT Five critical risk factors were identified to develop DVT: 1. Underlying cardiovascular disease 2. Underlying hematological disease 3. Underlying rheumatoid arthritis 4. Patients who took oral herbal medicine ...
Short-Term Coagulation Complications Following Total Knee Arthroplasty
The Journal of Arthroplasty, 2011
Data from 3278 patients from a prospective patient-centered total joint registry was used to investigate the rates of complications in the first 6 months following primary total knee arthroplasty. All patients reporting deep venous thrombosis (DVT), pulmonary embolism (PE), or major bleeding were identified through patient self-reporting. Complications were verified by a review of imaging records and direct communication with patients by a surgeon. Surgeon-verified rates of DVT, PE, and major bleeding were 1.52%, 0.49%, and 0.34%, respectively. When compared with the complication rates as reported by patients, concordance was 86.2% for DVT, 84.2% for PE, and 36.7% for major bleeding. More than half (54.5%) of the complications were diagnosed and treated at the original operative hospital, and 45.5% were diagnosed and treated at other institutions. Keywords: total knee arthroplasty, complications, deep vein thrombosis, pulmonary embolism, major bleeding, registry.
Open Journal of Orthopedics, 2019
Introduction: Total knee arthroplasty, being a major surgery, carries a risk of post-operative deep vein thrombosis (DVT). The main objective of the present study was to elucidate the association of clinical, laboratory, and echographic findings with the occurrence of DVT. Patients and Methods: The present study was prospective and non-randomized, with restricted exclusion criteria. Forty patients were submitted to total knee arthroplasty due to osteoarthritis. Patients were clinically evaluated by laboratory tests, assessment of pain and calf circumference, and the presence of Homans' sign. Echo Doppler was performed in each patient on postoperative day 7. The echographic evaluation divided the patients into two groups: positive (G1) and negative for thrombosis (G2). All patients received prophylactic heparin during the 7-day hospital admission. Results: Eleven patients complained of pain (analgesic medication was used during the entire admission). Leg circumference variation from the pre-operative period to post-operative day 7 was: G1, 1.70 ± 1.12 cm and G2, 0.68 ± 1.25 cm (p = 0.03). Homans' sign was considered positive in 10 patients. Echographic evaluation was positive in 11 patients (27.5%). No cases of pulmonary embolism, infection, or death were observed. Conclusions: The incidence of DVT was 27.5%, with an increase in leg circumference being the main predictive factor (p = 0.03).
Thrombosis Research, 2008
Background: There is a perception in the orthopaedic and thromboembolism community that the incidence of deep vein thrombosis (DVT) has decreased in patients undergoing total knee arthroplasty (TKA) or total hip arthroplasty (THA). Objectives: To assess the incidence of DVT with warfarin thromboprophylaxis over time in patients undergoing elective TKA or THA. Methods: The MEDLINE, EMBASE, and Cochrane Library databases were searched to October 2006, supplemented by a manual search of reference lists. Two reviewers independently extracted data on study characteristics, quality and the frequency of total, symptomatic and proximal DVT. Results: Fourteen studies (4,423 patients) were included. Total and proximal DVT after TKA declined over time (r = − 0.75, p = 0.031; r = −0.86, p = 0.007 respectively).
Thromboembolic disease after knee arthroplasty is rare in Southern Iran
Journal of Orthopaedics, 2015
Background: Thromboembolic disease (TED) after knee arthroplasty occurs infrequently in Iran. The aim of this study was to examine the incidence of TED in patients with osteoarthritis undergoing knee replacement in Southern Iran while on prophylaxis. In a case series study from January to December 2012, 100 consecutive total knee arthroplasty (TKA) candidates were evaluated for TED by clinical evaluation and Doppler sonography preoperatively and 2 months postoperatively and by clinical evaluation one year after surgery. The patients in this study randomly received either warfarin or enoxaparin prophylactically. Results: A total of 77 women and 23 men with mean age of 67 years (52e82 years) entered the study. The average hemoglobin drop of 2.7 g with warfarin and 3.3 with enoxaparin was observed. No case of TED, pulmonary embolus (PE), major bleeding, post-thrombotic syndrome, or hemarthrosis was observed. No clinically significant DVT was found using either enoxaparin or warfarin prophylaxis after TKA in Southern Iran. Relatively excessive postoperative bleeding was observed, particularly with enoxaparin.
Clinical Orthopaedics and Related Research®, 2010
Postthrombotic syndrome (PTS) is characterized by edema, venous ectasia, hyperpigmentation, varicose veins, venous ulceration, and pain with calf compression after deep venous thrombosis (DVT). We determined the incidence of PTS after DVT diagnosed on screening ultrasound in patients undergoing primary total knee arthroplasty (TKA) for osteoarthritis (OA). We retrospectively reviewed the records of 1406 patients who underwent primary TKA for osteoarthritis and compared the incidence of PTS in patients without and with DVT. All patients had postoperative screening ultrasound. From these 1406 patients we identified 66 (4.7%) who had DVT, 50 of whom had a minimum of 1 year followup (mean, 4.97 years; range, 1.00-7.53 years). PTS was diagnosed if any two of six signs were documented in the medical record. Three of 50 patients with DVT (6%) had signs consistent with PTS; two of these three had a DVT proximal to the soleal arch. Seven (8%) of 88 patients randomly chosen for primary TKA because of OA with similar mean age and gender, but without DVT, had signs of PTS. PTS does not seem to be a major sequela of DVT in patients undergoing primary TKA for OA.
BMC Musculoskeletal Disorders
Background: We sought to document the incidences of deep vein thrombosis (DVT) before and after total knee arthroplasty (TKA). In addition, we aimed to explor whether routine preoperative DVT evaluation was useful to establish DVT treatment strategies after TKA. Finally, we wanted to evaluate whether the incidences of DVT differed between patients undergoing unilateral and staged bilateral TKA within the same hospitalization period. Methods: The retrospective study included 153 consecutive patients (253 knees) with osteoarthritis who underwent primary TKA. After surgery, mechanical compression devices (only) were used for DVT prophylaxis. DVT status before and after TKA was determined via 128-row, multidetector, computed tomography/indirect venography. Results: Overall, the preoperative DVT incidence was 2.6% per patient and 1.6% per knee. All preoperative DVTs were distal in nature and asymptomatic. After TKA, newly developed thrombi were evident in various calf veins, without propagation of any pre-existing thrombi. Postoperatively, the overall incidences of DVT were 69.9% per patient and 58.5% per knee. The DVT incidences were 66% per patient and 69.8% per knee in the unilateral TKA group. In contrast, the incidences were 72% per patient and 55.5% per knee in the staged bilateral TKA group. There was one case of symptomatic distal (unilateral TKA; 0.65% per patient and 0.4% per knee) and proximal DVT (bilateral TKA; 0.65% per patient and 0.4% per knee), respectively. Conclusions: The incidence of symptomatic DVT was low in Asian patients treated with mechanical compression devices alone, although substantial portion of patients had DVT after surgery. Routine preoperative DVT evaluation is probably not necessary; preoperative DVT was rare and of limited clinical relevance. Furthermore, staged bilateral TKA during a single period of hospitalization does not increase the incidence of DVT.