Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?
J Knee Surg DOI: 10.1055/s-0039-1700976The aim of this study was to investigate the overall incidence of venous thromboembolism (VTE) and to assess the efficacy of chemoprophylaxis to prevent VTE following medial open-wedge high tibial osteotomy (MOWHTO) in Asian patients. A total of 133 patients who consecutively underwent MOWHTO for the treatment of knee osteoarthritis with varus deformity were enrolled. All patients underwent preoperative ultrasonography and computed tomography venography on postoperative day 5 to detect deep vein thrombosis (DVT). Patients were divided into two groups: chemoprophylaxis group included patients (n = 66) who received 2.5 mg fondaparinux for 5 days postoperatively, whereas control group comprised patients (n = 67) who received placebo (67 patients). We evaluated the efficacy and safety outcomes of the treatment. We also assessed the predisposing factors that may affect the occurrence of VTE. The incidence of overall DVT was 14.9% in the control group and 10.6% in the chemoprophylaxis group (p > 0.05). Proximal DVT occurred in one patient in the control group. There was no symptomatic DVT or pulmonary embolism in either group. The patients with DVT had significantly higher mean body mass index (BMI) than the patients without DVT. Multivariate logistic regression showed BMI > 30 kg/m2 that was significantly correlated with the development of DVT (odds ratio =&thi...
Conclusion: These updated French guidelines will contribute to increase the level of urological care for the diagnosis and treatment for NMIBC and MIBC. PMID: 32093463 [PubMed - in process]
We thank Dr Reiffel for his interest in our case description1 and his comments. Indeed, the presence of precordial T-wave inversions in the setting of pulmonary embolism has been described periodically in the literature. The cases described by Dr Reiffel supplement the cases we referenced in our report to reinforce this point. Two theories are often cited as an explanation for this finding. The first is heightened sympathetic tone caused by an autonomic nervous system –mediated response triggered by acute pulmonary embolism.
Publication date: March 2020Source: The Lancet Haematology, Volume 7, Issue 3Author(s): Stuart L Cohen, Chinara Feizullayeva, John A McCandlish, Pina C Sanelli, Thomas McGinn, Benjamin Brenner, Alex C Spyropoulos
Publication date: Available online 26 February 2020Source: Current Therapeutic ResearchAuthor(s): Patrice Vincent, Thibaut Lucas de Couville, Thierry Thomas
ConclusionsThe association of rs4867568 and rs143383 with KOA was successfully replicated in the Chinese Han population. Moreover, rs4867568 was found significantly associated with the severity of KOA. More studies are warranted to explore the functional role of rs4867568 in the development of KOA.Key Points• A novel variant near Lsp1p3 is associated with knee osteoarthritis.• Baseline characteristics of the subjects.• Comparison of the genotype and allele frequency of the Lsp1p3, GDF5, and FTO.• Association of the Lsp1p3, GDF5, and FTO with KOA severity.
CONCLUSIONS: New oral anticoagulants were associated with a lower risk of symptomatic DVT and symptomatic PE in this large, registry study, and we observed no differences in the risk of bleeding, reoperation, or death between the groups. Although we were able to control for a number of potential confounding variables, we cannot ascertain the indications that drove the prescription decisions in this setting, and there were important between-group differences in terms of duration of thromboprophylaxis (new oral anticoagulants generally were used for a longer period of time after surgery). Future studies, preferably large ran...
CONCLUSIONS The administration of tranexamic acid in two IV doses of 10-15 mg/kg to patients with total knee and hip arthroplasty has proven to be efficient. A higher efficacy of TXA was reported in TKA and due to routine administration of TXA the postoperative autotransfusion system (ORTHO P.A.S.) ceased to be used in knee replacement surgery. Key words:total hip arthroplasty, total knee arthroplasty, tranexamic acid, blood loss, allogeneic transfusion, autotransfusion, postoperative complications. PMID: 31070570 [PubMed - in process]
DiscussionSingle use of IPC device could not reach significant level of DVT prophylaxis compared to control group and only chemoprophylaxis showed significantly reduce the incidence of overall DVT following TKA. Single use of IPC device does not show effective thromboprophylaxis in a low DVT incidence population.Level of evidenceIII, case control study.
CONCLUSIONS More attention should be paid to the increased risk of wound complications and knee swelling associated with rivaroxaban, although the hidden blood loss was similar in both groups. PMID: 28174415 [PubMed - in process]
The objectives of our study were to analyze the demographic and perioperative factors of RA patients that may affect post-TKA outcomes, as well as to assess the 30-day complication rates compared to osteoarthritis patients. We retrospectively evaluated the National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2012 to assess all patients who underwent a primary TKA and had a diagnosis of rheumatoid arthritis (n = 141) or primary knee osteoarthritis (n = 7125). We evaluated and compared the demographic factors, social factors, preoperative factors, operative factors, and post...