Prevention of early complications following total hip replacement

Fontalis, Andreas; Berry, Daniel J.; Shimmin, A; Slullitel, Pablo; Buttaro, Martín; Cao, Li; Malchau, Henrik; Haddad, Fares S.

doi:10.1051/sicotj/2021060

Cited by 18 publications

(13 citation statements)

References 82 publications

(93 reference statements)

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“…The EPCAT III trial is an ongoing trial that will focus on comparing aspirin as a solo pharmacological agent to a combined regimen which will give us better clarity if the VTE rate would still be comparable without the initial transition phase. As stated by Fontalis et al, it is essential to accurately risk stratify patients into low-intermediate-high individuals as this will allow us to adjust our prophylaxis strategy accordingly [ 39 ] and therefore improve our overall VTE rates.…”

Section: Discussionmentioning

confidence: 99%

Is aspirin still relevant as a single pharmacological agent for venous thromboembolism prophylaxis post hip and knee arthroplasty surgery: A retrospective review

Pretorius

Nemat

Azeem

et al. 2022

SICOT-J

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Introduction: Aspirin is widely used for the prevention of venous thromboembolism (VTE) after total hip arthroplasty (THA) and total knee arthroplasty (TKA). It is well-established that the bleeding and wound complication risk for aspirin is low or equivalent to the other anticoagulant agents, but there is still ongoing controversy regarding the efficacy of aspirin for VTE prophylaxis. The current HSE (2012) guideline suggests 72 h of enoxaparin and 4 weeks of Aspirin therapy. But is this practice still relevant with more recent guidelines, NICE (2021) and SIGN (2014) suggesting that Aspirin is not recommended as a single pharmacological agent for VTE prophylaxis. Method: A Retrospective review was performed of a single centre, between January 2016 and May 2021 assessing for symptomatic VTE post-THA and TKA. All the patients received enoxaparin and aspirin as per the HSE guidelines. Using NIMIS we assessed which patients received a workup for potential symptomatic VTE and who had a confirmed VTE within 3 months post-surgery. The secondary outcome was mortality within 3 months post-surgery. Results: A total of 1178 patients (721 undergoing THR and 457 undergoing TKR) were included in the study. The number of patients who received a workup for potential symptomatic VTE was 124 of 1178 (10.53%). VTE occurred in 13 of 721 patients (1.80%) of the THR patients and 1 of 457 (0.22%) of the TKR patients, and a total of 14 of 1178 patients (1.19%). Of these 7 (0.59%) patients developed a DVT and 7 (0.59%) a PE. No patients suffered a fatal pulmonary embolism within 90 days of index surgery nor any other cause of mortality. Conclusion: Aspirin is not only still relevant but can be considered as one of the most optimal pharmacological agents in preventing VTE after THA and TKA.

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Section: Discussionmentioning

confidence: 99%

Is aspirin still relevant as a single pharmacological agent for venous thromboembolism prophylaxis post hip and knee arthroplasty surgery: A retrospective review

Pretorius

Nemat

Azeem

et al. 2022

SICOT-J

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“…Since its introduction, subsequent and numerous improvements in the surgical techniques and the materials used have rendered it safe, efficient, and overall successful operation, accompanied by high patient satisfaction rates [1]. However, every surgical procedure, irrespective of how well-designed and performed, may be accompanied by complications [2].…”

Section: Introductionmentioning

confidence: 99%

An Entrapped Vacuum Drainage Tube Between the Surfaces of a Dual-Mobility Cup Following Total Hip Arthroplasty

Papavasiliou¹,

Bouthors²,

Maigné³

et al. 2022

Cureus

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This paper aims to present the unique, to the best of our knowledge, case of entrapment of a standard vacuum drainage tube in the articulating surfaces of the cup of dual-mobility total hip arthroplasty. A 75year-old woman with end-stage idiopathic avascular necrosis of the left femoral head was referred to the arthroplasty service of our tertiary orthopedic department. She underwent a scheduled and uneventful total hip arthroplasty with a press-fit dual-mobility prosthesis through a standard posterior approach. On the second postoperative day, the attempt to remove the standard vacuum drainage was unsuccessful. Consequently, the patient underwent urgent re-operation. The drain tube was found entrapped between the articulating surfaces of the posterior-inferior aspect of the dual-mobility cup and was uneventfully removed. The patient was discharged with no further events three days after her second operation. Our unique rare case increases awareness when performing even routine everyday surgical procedures because a rare complication may occur irrespective of the level of vigilance of the surgeon and can potentially compromise the outcomes of an otherwise well-performed operation.

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“…27 The desire for short stems, bone preservation, and better load-transfer has paralleled the altering demographics of THA. 27 The role of RSA has once again been vital in assessing micromotion and adjudicating the safety of these designs. 4,21,28 Other potential applications of RSA include in vivo linear and volumetric wear using model-based radiostereometric analysis.…”

mentioning

confidence: 99%

“…Furthermore, there has been a sharp increase in the percentage of younger patients undergoing total hip arthroplasty (THA). 27 The desire for short stems, bone preservation, and better load-transfer has paralleled the altering demographics of THA. 27 The role of RSA has once again been vital in assessing micromotion and adjudicating the safety of these designs.…”

mentioning

confidence: 99%

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Roentgen stereophotogrammetric analysis: still a very valuable tool in the orthopaedic research armamentarium

Fontalis

Haddad

2022

Bone & Joint Research

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Prevention of early complications following total hip replacement

Cited by 18 publications

References 82 publications

Is aspirin still relevant as a single pharmacological agent for venous thromboembolism prophylaxis post hip and knee arthroplasty surgery: A retrospective review

Is aspirin still relevant as a single pharmacological agent for venous thromboembolism prophylaxis post hip and knee arthroplasty surgery: A retrospective review

An Entrapped Vacuum Drainage Tube Between the Surfaces of a Dual-Mobility Cup Following Total Hip Arthroplasty

Roentgen stereophotogrammetric analysis: still a very valuable tool in the orthopaedic research armamentarium

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