Rheumatoid arthritis: a risk factor for deep venous thrombosis after total knee arthroplasty? Comparative study with osteoarthritis

Niki, Yasuo; Matsumoto, Hideo; Hakozaki, Akihiro; Mochizuki, Takeshi; Momohara, Shigeki

doi:10.1007/s00776-009-1410-3

Cited by 49 publications

(45 citation statements)

References 24 publications

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“…After a detailed full-paper review, another 52 were excluded. A total of 8 articles [5][6][7][8][9][10][11][12] satisfied most of the inclusion criteria for data extraction after full review ( Figure 1): Seven observational cohort studies, and 1 randomized clinical trial. Of the 8 studies, 7 were retrospective, 1 was prospective.…”

Section: Study Identification and Selectionmentioning

confidence: 99%

“…A total of 8886 RA patients were included in our review. The agents for prophylaxis were: Nadroparine [5] , low doses of unfractionated heparin [6] , Aspirin [7] , Acenocumarol [8] and mechanical prophylaxes [10] . As can be observed in table 1, only 3 studies satisfied all the inclusion criteria [5,6,8] .…”

Section: Study Characteristicsmentioning

confidence: 99%

“…The agents for prophylaxis were: Nadroparine [5] , low doses of unfractionated heparin [6] , Aspirin [7] , Acenocumarol [8] and mechanical prophylaxes [10] . As can be observed in table 1, only 3 studies satisfied all the inclusion criteria [5,6,8] . In the other studies there were several bias: the prophylaxis utilized was not reported in 3 studies, the duration of prophylaxis was not indicated in 3, the method of surveillance for the diagnosis of VTE was not reported in 3, and the incidence of bleeding complications was not reported in 4 studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…A total of 4 studies which reported the incidence of VTE in RA patients and controls (mainly patients with Osteoarthrosis) undergoing orthopedic surgery were identified [6,7,9,10] and included in the meta-analysis. Three studies were excluded from the meta-analysis since the rate of VTE in RA patients was not reported.…”

Section: Rate Of Vtementioning

confidence: 99%

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Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Mameli¹

2014

WJO

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The risk of venous thromboembolism (VTE) in rheumatoid arthritis (RA) and the higher incidence of RA patients undergoing major orthopedic surgery is well recognized. The objective of the present study is to describe the incidence of VTE and discuss the correct prophylaxis in RA patients undergoing knee or hip replacement. A systematic review of studies on thromboprophylaxis in RA patients undergoing major orthopedic surgery was performed. Detailed information was extracted to calculate the rate of VTE in RA orthopedic patients and analyze the thromboprophylaxis performed and bleeding complications. Eight articles were eligible for full review. No difference in the overall rate of VTE was observed between RA patients and controls. No significant differences were found in RA patients in terms of bleeding complications. The data on the optimal prophylaxis to be used in RA patients were insufficient to recommend any of the several options available. In the absence of dedicated guidelines for the care of RA patients undergoing orthopedic surgery, management must be individualized to obtain favorable patient outcome, weighing up all the factors that might put the patient at risk for higher bleeding and thrombotic events.

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Section: Study Identification and Selectionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Rate Of Vtementioning

confidence: 99%

See 2 more Smart Citations

Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Mameli¹

2014

WJO

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“…83 There is also evidence that knee arthroplasty for a joint damaged by rheumatoid arthritis results in less DVT than knee arthroplasty to replace a joint damaged by osteoarthritis; however, this requires further investigation. 84 Early postoperative mobilisation can reduce relative VTE risk by 65%. [85][86][87] Conversely, an increased duration of anaesthesia (3.5+ hours) has been associated with an almost four times increased overall VTE risk in bilateral knee arthroplasty patients (7.5% vs. 30.2%).…”

Section: Other Influencing Factorsmentioning

confidence: 99%

Thromboprophylaxis Following Hip And Knee Arthroplasty

Mirkazemi¹,

Bereznicki²,

Peterson³

2012

Internal Medicine Journal

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A systematic review and meta‐analysis comparing complications following total joint arthroplasty for rheumatoid arthritis versus for osteoarthritis

Ravi¹,

Escott²,

Shah³

et al. 2012

Arthritis & Rheumatism

193

109

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Objective. Most of the evidence regarding complications following total hip arthroplasty (THA) and total knee arthroplasty (TKA) is based on studies of patients with osteoarthritis (OA), with little being known about outcomes in patients with rheumatoid arthritis (RA). The objective of the present study was to review the current evidence regarding rates of THA/TKA complications in RA versus OA.Methods. Data sources used were Medline, EMBase, Cinahl, Web of Science, and reference lists of articles. We included reports published between 1990 and 2011 that described studies of primary total joint arthroplasty of the hip or knee and contained information on outcomes in >200 RA and OA joints. Outcomes of interest included revision, hip dislocation, infection, 90-day mortality, and venous thromboembolic events. Two reviewers independently assessed each study for quality and extracted data. Where appropriate, metaanalysis was performed; if this was not possible, the level of evidence was assessed qualitatively.Results. Forty studies were included in this review. The results indicated that patients with RA are at increased risk of dislocation following THA (adjusted odds ratio 2.16 [95% confidence interval 1.52-3.07]). There was fair evidence to support the notion that risk of infection and risk of early revision following TKA are increased in RA versus OA. There was no evidence of any differences in rates of revision at later time points, 90-day mortality, or rates of venous thromboembolic events following THA or TKA in patients with RA versus OA. RA was explicitly defined in only 3 studies (7.5%), and only 11 studies (27.5%) included adjustment for covariates (e.g., age, sex, and comorbidity).Conclusion. The findings of this literature review and meta-analysis indicate that, compared to patients with OA, patients with RA are at higher risk of dislocation following THA and higher risk of infection following TKA.

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Rheumatoid arthritis: a risk factor for deep venous thrombosis after total knee arthroplasty? Comparative study with osteoarthritis

Cited by 49 publications

References 24 publications

Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Thromboembolic disease in patients with rheumatoid arthritis undergoing joint arthroplasty: Update on prophylaxes

Thromboprophylaxis Following Hip And Knee Arthroplasty

A systematic review and meta‐analysis comparing complications following total joint arthroplasty for rheumatoid arthritis versus for osteoarthritis

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