Prevention, Diagnosis and Treatment of Thromboembolic Complications in Traumatology and Orthopedics: Methodological Guidelines

Божкова, С. А.; Tikhilov, Rashid M.; Andriyashkin, V. V.; Akhtyamov, I. F.; Belov, Mikhail V.; Дианов, С. В.; Касимова, А. Р.; Каплунов, О.А.; Kopenkin, Sergei S.; Маланин, Д А; Муштин, Н. Е.; Цед, А. Н.

doi:10.17816/2311-2905-1993

Traumatology and Orthopedics of Russia

2022

DOI: 10.17816/2311-2905-1993

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Prevention, Diagnosis and Treatment of Thromboembolic Complications in Traumatology and Orthopedics: Methodological Guidelines

С. А. Божкова¹,

Rashid M. Tikhilov²,

V. V. Andriyashkin

et al.

Abstract: The guidelines describe modern approaches to the prevention, diagnosis, and treatment of thromboembolic complications in patients with injuries and after musculoskeletal surgery, in accordance with the interdisciplinary draft of the Clinical Guidelines (2022) Deep vein thrombosis of the extremities, which has passed public hearings and is being approved by the Russian Ministry of Health. The guidelines are designed for doctors of various specialties to provide medical care to specialized patients: orthopedic s… Show more

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Cited by 8 publications

References 112 publications

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Pharmacokinetics and bioequivalence of the generic and original dabigatran etexilate after a single dose in healthy volunteers

Vasilyuk,

Faraponova,

Verveda

et al. 2024

Russ J Cardiol

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Aim. To study the comparative pharmacokinetics and confirmation of bioequivalence of the generic (T) and original (R) dabigatran etexilate in healthy volunteers after a single oral dose under fasted conditions.Material and methods. To confirm bioequivalence, an open-label, randomized, replication, crossover, four-step study was conducted to compare the pharmacokinetics and bioequivalence of generic and original dabigatran with a single oral dose 150 mg dabigatran etexilate under fasted conditions in adult healthy male and female volunteers. Sixty-eight subjects participated in the study. During the study, blood plasma samples were taken from volunteers, in which the concentration of total and free dabigatran was determined. Based on the data obtained, pharmacokinetic and statistical analysis was carried out and 90% confidence intervals were calculated for the ratio of mean pharmacokinetic parameters (Сmax, Tmax, AUC0-t, AUC0-∞, AUCt-∞, T1/2, AUCt-∞/AUC0-∞) for total and free dabigatran.Results. The established 90% confidence intervals for the ratio of AUC0-t, AUC0-∞ and Cmax values for total dabigatran were 82,56-96,36% (mean ratio, 89,19%), 82,39-95,90% (mean ratio, 88,89%) and 85,98-99,17% (mean ratio, 92,34%), respectively. The established 90% confidence intervals for the ratio of AUC0-t, AUC0-∞ and Сmax values for free dabigatran were 83,37-98,29% (mean ratio, 90,53%), 82,98-97,33% (mean ratio, 89,87%) and 85,04-99,28% (mean ratio, 91,88%), respectively. For the estimated pharmacokinetic parameters of dabigatran etexilate, 90% confidence intervals ranged from 80-125% for AUC0-t, AUC0-∞ and Cmax. Additional safety analysis was carried out. Generic and original dabigatran were well tolerated by the volunteers. There were no significant differences in vital signs, paraclinical characteristics throughout the study compared with the initial data, as well as significant differences between the drugs in all studied parameters of adverse events.Conclusion. The study showed that generic and original dabigatran are bioequivalent. In addition, the data obtained indicate that the agents have similar safety profiles.

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Pharmacokinetics and bioequivalence of the generic and original dabigatran etexilate after a single dose in healthy volunteers

Vasilyuk,

Faraponova,

Verveda

et al. 2024

Russ J Cardiol

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Total Knee Arthroplasty in Hemodialysis Patients: Routine or Complex Surgery?

Tsed,

Mushtin,

Dulaev

et al. 2023

Traumatology and Orthopedics of Russia

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Background. Chronic hemodialysis significantly increases the risks associated with knee replacement. Among the late complications of knee arthroplasty in hemodialysis patients, deep periprosthetic joint infection (PJI) and aseptic loosening are more frequent. The frequency of revision interventions in patients with end-stage kidney disease (ESKD) is substantially higher compared to patients with normal kidney function. The aim of the study — based on the perioperative parameters and midterm outcomes to justify the primary knee replacement in chronic hemodialysis patients as complex case of arthroplasty. Methods. A retrospective randomized single-center cohort study was conducted, including 62 patients with various forms of knee osteoarthritis. Patients were divided into two groups: Group 1 — 29 (46.8%) patients with end-stage renal disease (ESRD) undergoing dialysis, Group 2 — 33 (53.2%) patients without kidney pathology. The average follow-up period in both groups was 3.7 years (min — 1, max — 6). The following parameters were assessed: patient age, length of hospital stay, morphocortical index, body mass index (BMI), duration of hemodialysis, functional assessment of the knee joint using the KSS Function Score and Forgotten Joint Score-12 (FJS-12), radiological results on the KRESS, and the frequency of various complications. Results. In Group 1, patients had significantly lower BMI compared to Group 2. Length of hospital stay in Group 1 were 1.7 times longer. According to the KSS Function Score, no significant differences were observed between the groups in the first 36 months after the operation. However, by the 4th year of follow-up, average KSS Function Score in Group 1 decreased to 77.3 points, which was due to infectious complications. The FJS-12 showed worse scores in Group 2, averaging 68.7 points. After more than three years post-operation, no statistically significant differences were observed between the groups, which was associated with an increase in the number of complications in Group 1. Results on the KRESS after 43 months did not differ between the groups and averaged 4.8 points. Group 1 had more orthopedic complications and cases of PJI, accounting for 7 out of 37. Conclusion. Age and constitutional characteristics of patients undergoing hemodialysis significantly differ from the normal population. The frequency of complications in Group 1 was 23.5%. These patients require the implantation of more constrained implant components and modular systems. Therefore, primary knee replacement in hemodialysis patients can be classified as a complex case of arthroplasty.

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Prevention of postoperative pain after total hip arthroplasty in patients with proximal femur fractures

Han,

Akhtiamov,

Ardashev

et al. 2023

jour

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Introduction Proximal femur fractures can be associated with nailing and total hip arthroplasty (THA). Treatment of elderly inpatients necessitates adequate postoperative pain relief. Obese patients require specific inpatient and outpatient treatments.The objective was to evaluate the effectiveness of pain relief in obese patients at the stages of rehabilitation after primary THA performed for a proximal femur fracture.Material and methods VAS score was compared in two groups of 60 clinical cases to evaluate the effectiveness of postoperative multimodal pain relief using the author's method.Results Comparable results of an effective and stable pain relief were obtained in the two groups by the time the patient was discharged from the hospital 5-6 days after THA. Multimodal analgesia with a glucocorticosteroid injected in the projection of the sacroiliac joint provided an effect being greater by 29 % than with use of opioids after two postoperative days and by 11 % after five postoperative days.Discussion Old age, comorbidities are associated with optimal surgical strategy. THA in patients with extra-articular proximal femur fractures can improve the rehabilitation potential early after surgery and general clinical and functional results providing high quality of life in the late rehabilitation period.Conclusion THA demonstrated a stable positive effect of pain relief in the study group of patients with proximal femur fractures, regardless of the weight and the height. Positive dynamics in pain relief was seen in patients with elevated BMI of any gradation, including those with BMI ≥ 40.

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Prevention, Diagnosis and Treatment of Thromboembolic Complications in Traumatology and Orthopedics: Methodological Guidelines

Cited by 8 publications

References 112 publications

Pharmacokinetics and bioequivalence of the generic and original dabigatran etexilate after a single dose in healthy volunteers

Pharmacokinetics and bioequivalence of the generic and original dabigatran etexilate after a single dose in healthy volunteers

Total Knee Arthroplasty in Hemodialysis Patients: Routine or Complex Surgery?

Prevention of postoperative pain after total hip arthroplasty in patients with proximal femur fractures

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