Preventing VTE following total hip and knee arthroplasty: Is prediction the future?

Nemeth, Banne; Nelissen, Rob G H H; Arya, Roopen; Cannegieter, Suzanne C.

doi:10.1111/jth.15132

Cited by 29 publications

(18 citation statements)

References 21 publications

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“…Studies[ 18 – 20 ] have shown that the incidence of DVT in patients treated with THA is 14.13-20.18 %. The results of this study indicate that the incidence of lower limb DVT in patients after THA is 19.78 %, which is lower than the previous report[ 21 , 22 ]. It may be related to the differences in the conditions of included patients, surgical method and perioperative preventive anticoagulation treatment amongst different studies.…”

Section: Discussioncontrasting

confidence: 73%

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

Ning

2021

BMC Musculoskelet Disord

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Background Deep vein thrombosis (DVT) of lower limb is one of the common complications after total hip arthroplasty(THA), we aimed to evaluate the potential risk factors of DVT of lower limb in patients with THA, to provide insights into the management of THA. Methods Patients who underwent THA in our hospital from January 1, 2017 to November 30, 2020 were included. The personal characteristics and clinical data of DVT and no-DVT patients were compared and analyzed. Logistic regression analyses were perfomed to identify the potential risk factors of DVT in patients with THA. Results A total of 182 THA patients were included, the incidence of DVT of lower limb in patients with THA was 19.78 %. There were significant differences in the age, BMI, diabetes, number of replacement, duration of surgery, type of prosthesis and duration of days in bed between DVT and no-DVT patients(all P < 0.05). And there were no significant differences in the gender, hypertension, hyperlipidemia, preoperative D-dimer, type of anesthesia and anticoagulant drugs use(all P > 0.05). Logistic regression analysis indicated that age > 70y(OR4.406, 95 %CI1.744 ~ 6.134), BMI ≥ 28(OR2.275, 95 %CI1.181 ~ 4.531), diabetes(OR3.949, 95 %CI1.284 ~ 5.279), bilateral joint replacements(OR2.272, 95 %CI1.402 ~ 4.423), duration of surgery ≥ 120 min(OR3.081, 95 %CI1.293 ~ 5.308), cemented prosthesis(OR2.435, 95 %CI1.104 ~ 4.315), and duration of days in bed > 3 days(OR1.566, 95 %CI1.182 ~ 1.994) were the risk factors of DVT of lower limb in patients with THA. Conclusions DVT in the lower limb after THA is common, and its onset is affected by many factors. In clinical work, attention should be paid to identify the risk factors for DVT and targeted interventions are highlighted to prevent the postoperative DVT.

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Section: Discussioncontrasting

confidence: 73%

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

Ning

2021

BMC Musculoskelet Disord

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“…Nearly 2.5 million patients who suffer from joint dysfunction caused by diseases such as hip and knee osteoarthritis undergo arthroplasty surgery each year worldwide ( Nemeth et al, 2021 ). Artificial joint replacement has gained ground as one of the most effective treatments for articular diseases for which conservative approaches fail.…”

Section: Discussionmentioning

confidence: 99%

Cimifugin Suppresses NF-κB Signaling to Prevent Osteoclastogenesis and Periprosthetic Osteolysis

Duan

et al. 2021

Front. Pharmacol.

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Background: Aseptic loosening of prosthesis (ALP) is one of the most common long-term complications of knee and hip arthroplasty. Wear particle-induced osteoclastogenesis and subsequent periprosthetic osteolysis account for the morbidity of ALP. Here, we investigate the potential of cimifugin (CIM), a natural extract from Cimicifuga racemosa and Saposhnikovia divaricata, as a bone-protective drug in the treatment of ALP.Method: First, we performed cell viability and osteoclast formation assays to assess the effect of noncytotoxic CIM on osteoclast differentiation in vitro. Bone slice resorption and F-actin ring immunofluorescence assays were adopted to assess the effects of CIM on bone-resorption function. Then, quantitative real-time polymerase chain reaction (qRT–PCR) analysis was performed to further assess the repressive effects of CIM on osteoclastogenesis at the gene expression level. To elucidate the mechanisms underlying the above findings, Western blot and luciferase reporter gene assays were used to assess the regulatory effects of CIM on the NF-κB and MAPK signaling pathways. Moreover, a Ti particle-induced murine calvarial osteolysis model and subsequent histomorphometric analysis via micro-CT and immunohistochemical staining were used to elucidate the effect of CIM on periprosthetic osteolysis in vivo.Result: CIM dose-dependently inhibited both bone marrow-derived macrophage (BMM)- and RAW264.7 cell-derived osteoclastogenesis and bone resorption pit formation in vitro, which was further supported by the reduced expression of F-actin and osteoclast-specific genes. According to the Western blot analysis, inhibition of IκBα phosphorylation in the NF-κB signaling pathway, not the phosphorylation of MAPKs, was responsible for the suppressive effect of CIM on osteoclastogenesis. Animal experiments demonstrated that CIM alleviated Ti particle-induced bone erosion and osteoclast accumulation in murine calvaria.Conclusion: The current study suggested for the first time that CIM can inhibit RANKL-induced osetoclastogenesis by suppressing the NF-κB signaling pathway in vitro and prevent periprosthetic osteolysis in vivo. These findings suggest the potential of CIM as a therapeutic in ALP.

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“…While this score requires external validation, it may be useful in identifying low risk patients who may safely avoid extended prophylaxis. A similar risk assessed approach has been suggested in patients undergoing orthopaedic surgery (35) and has been shown to be successful in cancer patients undergoing chemotherapy (36,37).…”

Section: Discussionmentioning

confidence: 99%

Extended thromboprophylaxis post gynaecological cancer surgery; the effect of weight adjusted and fixed dose LMWH (Tinzaparin)

Saadeh¹,

Marchocki²,

O’Toole

et al. 2021

Thrombosis Research

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Preventing VTE following total hip and knee arthroplasty: Is prediction the future?

Cited by 29 publications

References 21 publications

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

The deep vein thrombosis of lower limb after total hip arthroplasty: what should we care

Cimifugin Suppresses NF-κB Signaling to Prevent Osteoclastogenesis and Periprosthetic Osteolysis

Extended thromboprophylaxis post gynaecological cancer surgery; the effect of weight adjusted and fixed dose LMWH (Tinzaparin)

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