Review Article: Venous Thromboembolism after Total Joint Replacement

Leung, Katherine; Chiu, K. Y.; Yan, Chun Hoi; Ng, Florrie Fei Yin; Chan, Ping Keung

doi:10.1177/230949901302100318

Cited by 5 publications

(3 citation statements)

References 115 publications

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“…Other complications like pulmonary embolisms, deep venous thrombosis and major bleedings remained less than 0.3% which are considered very low as compared with hip and knee arthroplasty. 54,55 The risk of major arterial injury is low with MSP and MIS approaches as compared with ilioinguinal approach which has been reported to have a higher incidence of femoral artery thrombosis. 11,27 Malviya et al 56 analysed the incidence of stress fracture after PAO in 359 patients.…”

Section: Not Reportedmentioning

confidence: 99%

Complications and outcome after periacetabular osteotomy - influence of surgical approach

Ali

Malviya

2019

HIP International

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Background: Bernese periacetabular osteotomy (PAO) was introduced by Ganz as a novel surgical technique for hip dysplasia with a congruent hip to reorient the acetabulum in skeletally mature patients. The PAO through a modified Smith-Petersen (Iliofemoral) approach, has been subject to many modifications in order to avoid complications and to minimise risks for failure. Aim: The aim of this review was to report on the complication rates, functional and radiological outcomes in relation to surgical approaches. Methods: A search of NICE healthcare database advanced search, was conducted from the year of inception to May 2018. We included studies that reported complications of PAO. Data extracted from case series was analysed to detect the incidence of complications, relation to surgical approach and temporal trend of complications. Results: 40 studies including 4070 hips with a mean age of 29 years and a mean follow-up of 52.8 month, were analysed. Outcome measures demonstrated good to excellent outcome in 82%. Higher rates of LFCN and sciatic nerve injuries were found to be associated with the ilioinguinal and the 2-incision approach. Minimally invasive (MIS) modified Smith-Petersen (MSP), minimally invasive trans-sartorial and trans-trochanteric approaches were not reported to be associated with any major wound complications. Radiological correction achieved with a mean improvement in acetabular inclination of 17.90 (range 4.5–40), anterior centre-edge correction 25.40 (range 10–51), lateral centre-edge correction 23.30 (range 15–44.6) and medial translation of 6 mm (range 3.2–10). Conclusions: The complication rates seem to be lower in this current review (7%) as compared to the previous review performed by Clohisy et al. (6–37%). The MIS trans-sartorial/MIS MSP and intertrochanteric approaches are associated with an even reduced complications rates. This review enables favouring the minimally invasive approaches with regard to reducing nerve injury and wound complications.

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Section: Not Reportedmentioning

confidence: 99%

Complications and outcome after periacetabular osteotomy - influence of surgical approach

Ali

Malviya

2019

HIP International

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“…This has led to venographic evidence of asymptomatic DVT being used as an endpoint for determining efficacy of VTE prophylaxis. The objectivity of venographic studies is helpful to researchers since many DVT are clinically silent 1211,1229 .…”

Section: -Is Administration Of Any Venous Thromboembolism (Vte) Proph...mentioning

confidence: 99%

Recommendations from the ICM-VTE: General

2022

Journal of Bone and Joint Surgery

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“…Our findings are in agreement with these studies. However, the incidence of thromboembolic events after TKA varies from 1% to 84% [ 18 ]. This variation is likely due to the heterogeneity in study groups and the discrepancy in the methods used to evaluate the incidence in the literature.…”

Section: Discussionmentioning

confidence: 99%

Safety and Blood Loss Associated With Tourniquets in Total Knee Arthroplasty

Arafah¹,

Alotaibi²,

Alsalloum³

et al. 2021

Cureus

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To measure total blood loss and safety of tourniquets, tourniquets during cementation, or no tourniquets during total knee arthroplasty (TKA). MethodsThis retrospective cohort study included 75 patients from King Khalid University Hospital in Riyadh, Saudi Arabia. Patients were equally divided into three groups: tourniquets, no-tourniquets, and tourniquets during cementation. Recorded data included: baseline characteristics (age, sex, weight, height, body mass index (BMI), anesthesia type, and comorbidities), blood loss parameters (total blood loss, preoperative and postoperative hematocrit (Hct) and hemoglobin (Hgb), and blood transfusion units), duration of surgery, hospital stay, and thromboembolic events during 3-months postoperatively. Statistical significance was reported by using a P-value < 0.05, and 95% confidence intervals. ResultsThe tourniquet group had significantly lower mean total blood loss (544.67 mL ± 418.86; P = 0.001), higher mean postoperative hemoglobin values (115.44 g/dL ± 10.97; P = 0.004) and hematocrit (34.25 % ± 3.35; P = 0.005), and lower median intra-operative loss (100 cc, 10-300; P < 0.001), than the other groups. Tourniquets during cementation required significantly more mean surgery time (131.84 minutes ± 22.12; P = 0.003), and longer median hospital stay (8 days, 5-13) than the other groups. ConclusionTourniquet use during TKA significantly decreased total and intraoperative blood loss, but it did not have any significant effect on the transfusion rate or the incidence of thromboembolic events.

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Review Article: Venous Thromboembolism after Total Joint Replacement

Cited by 5 publications

References 115 publications

Complications and outcome after periacetabular osteotomy - influence of surgical approach

Complications and outcome after periacetabular osteotomy - influence of surgical approach

Recommendations from the ICM-VTE: General

Safety and Blood Loss Associated With Tourniquets in Total Knee Arthroplasty

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