Effects of Total Hip Replacement and Bed Rest on Blood Rheology and Red Cell Metabolism

Kaperonis, A. A.; Michelsen, Christopher B.; Askanazi, Jeffrey; Kinney, John M.; Chien, Shu

doi:10.1097/00005373-198804000-00006

Cited by 15 publications

(7 citation statements)

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“…5 The plasma CRP level reached its peak more rapidly than did the ESR, indicating that CRP levels are more responsive, a finding consistent with the literature. 2,5,7,9,11,19,21 Statistically significant differences between ESRs on day 1 after surgery in our THR and TKR patients may be attributable to haemodynamic changes resulting from plasma and blood transfusions during THR operations, as mentioned in earlier reports. 2,11 In our study, ESRs at the end of the third month in THR patients and at the end of the ninth month in TKR patients did not differ significantly from pre-operative values.…”

Section: Crp Values and Esrs After Arthroplastysupporting

confidence: 69%

“…3,16 -18 The CRP level reacts more rapidly and is more sensitive than is the ESR. 2,5,7,9,11, 19,20 Further, the use of cement and tourniquets in operations does not appear to affect CRP levels or ESRs. 6,10,11,20,22 Previous studies have reported that plasma CRP levels in THR and TKR patients increase rapidly after operation reaching maximum values within 2 -3 days, after which they decrease rapidly.…”

Section: Discussionmentioning

confidence: 96%

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C-Reactive Protein Values and Erythrocyte Sedimentation Rates after Total Hip and Total Knee Arthroplasty

et al. 2001

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We studied the changes in serum C-reactive protein levels (CRP) and erythrocyte sedimentation rates (ESR) in patients with primary osteoarthritis, who underwent uncomplicated arthroplasty. Of the 28 patients studied, 12 had cementless total hip replacement (THR), and 16 underwent cemented total knee replacement (TKR) with a tourniquet. In both groups serum CRP levels increased rapidly after surgery, peaking on day 2 (THR 23.17 mg/dl, TKR 26.02 mg/dl), and dropping gradually to pre-operative values on day 21 in THR patients and at the end of the second month in TKR patients. ESR peaked on day 5 after operation (THR 100.5 mm/h, TKR 101.3 mm/h), dropping close to pre-operative values at the end of the third month in THR patients and at the end of the ninth month in TKR patients, although, even after a year, ESRs were slightly above their pre-operative values. Serum CRP levels changed more rapidly than ESRs and returned to normal more rapidly. CRP and ESR values tended to be higher in TKR than in THR patients.

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Section: Crp Values and Esrs After Arthroplastysupporting

confidence: 69%

Section: Discussionmentioning

confidence: 96%

C-Reactive Protein Values and Erythrocyte Sedimentation Rates after Total Hip and Total Knee Arthroplasty

et al. 2001

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“…These changes occur in surgical as well as in matched immobilized medical controls, albeit with less tendency to increased blood viscosity (24). Rheologic changes were found in bedridden patients with bone fractures on admission but returned to normal after 30 days (25).…”

Section: Discussionmentioning

confidence: 99%

Is prolonged immobilization a risk factor for symptomatic venous thromboembolism in elderly bedridden patients?

Gatt¹,

Paltiel²,

Bursztyn³

2004

Thromb Haemost

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Prolonged immobilization and advanced age are considered to be important risk factors for venous thromboembolism (VTE). Nevertheless, the need for VTE prophylaxis in long-term bedridden patients is not known. To assess whether very prolonged immobilization (i.e. over three months) carries an increased risk for clinically apparent VTE, we performed a historical-cohort study of nursing home residents during a ten-year period. Data concerning patient's mobility and incidence of overt deep vein thrombosis or pulmonary embolism were registered. The mean resident age was 85+/-8.4 years. Eighteen mobile and eight immobile patients were diagnosed with clinically significant thromboembolic events, during 1137 and 573 patient-years of follow up, respectively. The incidence of venous thromboembolic events was similar in both chronically immobilized and mobile patient groups, 13.9 and 15.8 per thousand patient years, respectively (p=0.77). The rate ratio for having a VTE event in the immobilized patient group as compared with the mobile group was 0.88 (95% Confidence Interval (CI) 0.33 to 2.13). When taking into account baseline characteristics, risk factors and death rates by various causes, no differences were found between the two groups. In conclusion, chronically immobile bedridden patients are no more prone to clinically overt venous thromboembolic events than institutionalized mobile patients. Until further studies are performed concerning the impact of very prolonged immobilization on the risk of VTE, there is no evidence to support primary prevention after the first three months of immobilization. Evidence for efficacy or cost effectiveness beyond this early period is not available.

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“…According to the classic theory of Virchow, venous wall injury, slow blood flow, and hypercoagulability are the three factors that cause DVT [ 10 ]. Kaperonis et al found that 5-day bed rest in a normal person results in sluggish blood flow, increased aggregation of red blood cells, and increased blood viscosity [ 11 ]. Furthermore, because of long-term fixation and traction in patients with lower extremity fractures, their physical activity was reduced and the bedtime was prolonged, leading to muscle atrophy and blood coagulation, which could induce DVT.…”

Section: Introductionmentioning

confidence: 99%

Deep Vein Thrombosis in the Uninjured Limb in Patients with Lower Extremity Fractures: A Retrospective Study

Wang

Fei

et al. 2020

BioMed Research International

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Objective. This study is aimed at investigating the incidence of deep vein thrombosis (DVT) in the uninjured limb during hospitalization and 1 month after surgery in patients with lower extremity fractures. Methods. We collected the clinical data of patients with lower extremity fractures in Xi’an Honghui Hospital. Doppler ultrasonography was used to diagnose DVT. According to the results of ultrasonography, the patients were divided into two groups: uninjured limb with DVT group and uninjured limb without DVT group. Results. A total of 494 patients who met all inclusion criteria were included in this study. The incidence rate of DVT in the uninjured limb was 19.84% and 18.83% during hospitalization and 1 month after surgery, respectively. Age (OR=1.035, 95% CI: 1.013–1.059; P=0.002) and D-dimer level 1 day after surgery (OR=1.065, 95% CI: 1.030–1.102; P<0.001) were independent risk factors for DVT during hospitalization. Similarly, age (OR=1.045, 95% CI: 1.021–1.070; P<0.001) and D-dimer level 1 day after surgery (OR=1.048, 95% CI: 1.014–1.083; P=0.006) were independent risk factors for DVT 1 month after surgery. During hospitalization and 1 month after surgery, 15.79% and 12.35% of patients had double lower limb thrombosis and 4.04% and 6.48% of patients had DVT in the uninjured limb only, respectively. Conclusion. The actual incidence of DVT in the uninjured limb in patients with lower extremity fractures cannot be ignored despite the use of anticoagulants for prevention or treatment during hospitalization. We should also be aware of DVT in the uninjured limb while focusing on DVT in the injured limb.

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Effects of Total Hip Replacement and Bed Rest on Blood Rheology and Red Cell Metabolism

Cited by 15 publications

References 0 publications

C-Reactive Protein Values and Erythrocyte Sedimentation Rates after Total Hip and Total Knee Arthroplasty

C-Reactive Protein Values and Erythrocyte Sedimentation Rates after Total Hip and Total Knee Arthroplasty

Is prolonged immobilization a risk factor for symptomatic venous thromboembolism in elderly bedridden patients?

Deep Vein Thrombosis in the Uninjured Limb in Patients with Lower Extremity Fractures: A Retrospective Study

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