Trends in deep vein thrombosis prophylaxis after total hip arthroplasty: 2016 to 2021

Moore, Mallory C.; Dubin, Jeremy A.; Bains, Sandeep S.; Hameed, Daniel; Nace, James; Delanois, Ronald E.

doi:10.1016/j.jor.2023.11.030

Cited by 5 publications

(1 citation statement)

References 52 publications

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“…The use of aspirin in combination with celecoxib after total joint replacement may increase the risk of stroke, and the combination of celecoxib + ibuprofen may lead to an increased chance of periprosthetic joint infection (PJI), according to a study by H. Nakata et al ( Nakata et al, 2023 ). However, according to two studies on the use and safety of aspirin, the use of aspirin for the prevention of DVT after total hip arthroplasty is increasing and its safety profile is not significantly different from that of other anticoagulants ( Matharu et al, 2020 ; Moore et al, 2024 ). Besides, a study by A. Lalmohamed et al found that the risk of ischemic stroke was reduced by 70% in patients who used vitamin K antagonists and antiplatelet drugs after surgery, compared to those who did not use any antithrombotic drugs.…”

Section: Discussionmentioning

confidence: 99%

Mendelian randomization of stroke risk after total hip and knee replacements

Pang,

Zheng,

et al. 2024

Front. Genet.

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ObjectivePrevious epidemiological studies have indicated an increased risk of neurovascular diseases in patients following total hip and knee replacements. However, definitive conclusions regarding the increased risk of stroke post-replacement remain elusive. Therefore, we conducted a two-sample Mendelian randomization study to investigate the causal relationship between total hip and knee replacements and stroke.MethodsWe utilized summary data from publicly available genome-wide association studies (GWAS). Data concerning total hip replacements (THR, N = 319,037) and total knee replacements (TKR, N = 252,041) were sourced from the Genetics of Osteoarthritis (GO) Consortium. Stroke-related data were obtained from the International Stroke Genetics Consortium, encompassing any stroke (AS), any ischemic stroke (AIS), large vessel ischemic stroke (LV-IS), cardioembolic ischemic stroke (CE-IS), and small vessel ischemic stroke (SV-IS). Our primary causal inference method was the inverse variance weighted (IVW) approach, supplemented by weighted median and MR-Egger regression as secondary inference methods. We utilized the MR-PRESSO global test for outlier detection, Cochran’s Q statistic to assess heterogeneity, and assessed the multiplicity and stability of our findings using p-values from MR-PRESSO and MR-Egger regressions, and the leave-one-out method, respectively.ResultsWe identified significant genetic associations between THR and both AS (IVW p = 0.0001, OR = 1.08, 95% CI = 1.04–1.12) and AIS (IVW p = 0.0016, OR = 1.07, 95% CI = 1.03–1.12). Significant associations were also observed between TKR and AS (IVW p = 0.0002, OR = 1.08, 95% CI = 1.04–1.12), as well as AIS (IVW p = 0.0005, OR = 1.15, 95% CI = 1.06–1.24).ConclusionOur findings genetically support an increased risk of stroke following total hip and knee replacements. However, further studies are necessary to elucidate the specific mechanisms underlying stroke episodes post-replacement.

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Section: Discussionmentioning

confidence: 99%

Mendelian randomization of stroke risk after total hip and knee replacements

Pang,

Zheng,

et al. 2024

Front. Genet.

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Total Hip Arthroplasty in Patients Who Have Factor V Leiden: Elevated Risks Isolated to Venous Thromboembolism Events

Sanchez,

Jiang,

Dhodapkar

et al. 2024

The Journal of Arthroplasty

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American Association for the Surgery of Trauma/American College of Surgeons Committee on trauma clinical protocol for post-discharge venous thromboembolism prophylaxis after trauma

Berndtson,

Cross,

Yorkgitis

et al. 2024

J Trauma Acute Care Surg

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Trauma patients are at an elevated risk for developing venous thromboembolism (VTE), which includes pulmonary embolism and deep vein thrombosis. In the inpatient setting, prompt pharmacologic prophylaxis is utilized to prevent VTE. For patients with lower extremity fractures or limited mobility, VTE risk does not return to baseline levels post-discharge. Currently, there are limited data to guide post-discharge VTE prophylaxis in trauma patients. The goal of these post-discharge VTE prophylaxis guidelines are to identify patients at the highest risk of developing VTE after discharge and to offer pharmacologic prophylaxis strategies to limit this risk.

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Trends in deep vein thrombosis prophylaxis after total hip arthroplasty: 2016 to 2021

Cited by 5 publications

References 52 publications

Mendelian randomization of stroke risk after total hip and knee replacements

Mendelian randomization of stroke risk after total hip and knee replacements

Total Hip Arthroplasty in Patients Who Have Factor V Leiden: Elevated Risks Isolated to Venous Thromboembolism Events

American Association for the Surgery of Trauma/American College of Surgeons Committee on trauma clinical protocol for post-discharge venous thromboembolism prophylaxis after trauma

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