The effect of anticoagulants on venous thrombosis prevention after knee arthroscopy: a systematic review

Huang, Haifeng; Tian, Jialiang; Li, Sun; Yang, Xinyu; Shen, Yukun; Li, Shanshan; Xie, Qiuling; Tian, Xiaobin

doi:10.1007/s00264-018-4212-4

Cited by 14 publications

(21 citation statements)

References 33 publications

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“…1,2,7,17 Since VTE is relatively low after AKS, routine thromboprophylaxis is not recommended after these operations. 1,2,7,[17][18][19]22,23 There are many studies to clarify this subject in the literature; however, none of them are about the older population in which the risk is even higher for thromboembolic events. [1][2][3]7,[18][19][20][21][22][23][24] Arthroscopic knee surgery is the most common orthopedic operation throughout the world; therefore, understanding the risk is very important to develop guidelines and possible patterns for surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,7,[17][18][19]22,23 There are many studies to clarify this subject in the literature; however, none of them are about the older population in which the risk is even higher for thromboembolic events. [1][2][3]7,[18][19][20][21][22][23][24] Arthroscopic knee surgery is the most common orthopedic operation throughout the world; therefore, understanding the risk is very important to develop guidelines and possible patterns for surgeons. 7,[17][18][19]22,23 The total incidence of DVT in following AKS was relatively low (0.79%) in this study, and it was comparable with the literature.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3]7,[18][19][20][21][22][23][24] Arthroscopic knee surgery is the most common orthopedic operation throughout the world; therefore, understanding the risk is very important to develop guidelines and possible patterns for surgeons. 7,[17][18][19]22,23 The total incidence of DVT in following AKS was relatively low (0.79%) in this study, and it was comparable with the literature. 1,2,19,[21][22][23] However, when the incidence of the patients older than 40 years was compared with the incidence of the younger patients, an approximately 6-fold increase that was statistically significant (P ¼ .014) was observed.…”

Section: Discussionmentioning

confidence: 99%

“…4 These studies suggest that DVT incidence was decreased with thromboprophylaxis; however, many of them were subclinical, which may not require treatment with the potential risk of bleeding. [17][18][19]22,23 Recent meta-analyses about the effect of anticoagulants on VTE prevention suggest that anticoagulation therapy following AKS is ineffective, and they do not recommend routine prophylaxis because 7,[17][18][19]22,23 the incidence is still very low, and many DVTs are clinically unimportant. However, in the relatively older age group, some well-known risk factors were discussed in this article.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 Although some authors recommend routine prophylaxis after AKS, routine prophylaxis is not recommended in the guidelines. [1][2][3]7,[17][18][19] All these studies were conducted on the entire population or adolescents. There is no clear data about DVT in the middle-aged or elderly population following AKS in the literature.…”

Section: Introductionmentioning

confidence: 99%

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Symptomatic Deep Vein Thrombosis Following Elective Knee Arthroscopy Over the Age of 40

Özcan

Erem

Turan

2019

Clin Appl Thromb Hemost

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Thromboprophylaxis following arthroscopic knee surgery (AKS) is not clear in the literature. The purpose of this study was to present the incidence of symptomatic deep vein thrombosis (DVT) following elective AKS over the age of 40. The secondary purpose was to investigate risk factors associated with venous thromboembolic events (VTEs). Surgical database and outpatient clinic follow-up charts of the patients who underwent AKS for any reason were included in the study. Odds for risk factors such as previous medical history of thrombosis, any family history for clotting disorders, diabetes mellitus (DM), oral contraceptive usage, body mass index, history of malignancy, and smoking were evaluated. The incidence of DVT following AKS significantly increased in the patients older than 40 years who had a previous medical history of VTE, DM, and smoking. A variety of guidelines exist for VTE prophylaxis; however, one should focus on risk factors related to the patient’s medical history and current medical conditions. In this study, smoking, DM, and previous history of DVT increased DVT risk significantly, and thromboprophylaxis should be kept in mind for these patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Symptomatic Deep Vein Thrombosis Following Elective Knee Arthroscopy Over the Age of 40

Özcan

Erem

Turan

2019

Clin Appl Thromb Hemost

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Effect of lower‐leg trauma and knee arthroscopy on procoagulant phospholipid‐dependent activity

Touw

Nemeth

Lijfering

et al. 2022

Research and Practice in Thrombosis and Haemostasis

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Background Lower‐leg injury and knee arthroscopy are both associated with venous thromboembolism (VTE). The mechanism of VTE in both situations is unknown, including the role of procoagulant microparticles. This may provide useful information for individualizing thromboprophylactic treatment in both patient groups. Objective We aimed to study the effect of (1) lower‐leg trauma and (2) knee arthroscopy on procoagulant phospholipid‐dependent (PPL) activity plasma levels. Methods POT‐(K)CAST trial participants who did not develop VTE were randomly selected for the current study. Plasma was collected shortly after lower‐leg trauma or before and after knee arthroscopy. For aim 1, samples of 67 patients with lower‐leg injury were compared with control samples (preoperative samples of 74 patients undergoing arthroscopy). Linear regression was used to obtain mean ratios (natural logarithm retransformed data), adjusted for age, sex, body mass index, infections, and comorbidities. For aim 2, pre‐ and postoperative samples of 49 patients undergoing arthroscopy were compared using paired t tests. PPL activity was measured using modified activated factor X–dependent PPL clotting assay. Results For aim 1, PPL activity levels were almost threefold higher in patients with lower‐leg injury compared with controls, that is, mean ratio, 2.82 (95% confidence interval [CI], 1.98‐4.03). For aim 2, postoperative PPL activity levels did not change significantly, that is, mean change, −0.72 mU/mL (95% CI, −2.03 to 0.59). Conclusion Lower‐leg trauma was associated with increased plasma levels of PPL activity, in contrast to knee arthroscopy. Lower‐leg trauma triggers the release of procoagulant microparticles.

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Propidium monoazide–polymerase chain reaction for detection of residual periprosthetic joint infection in two-stage revision

et al. 2019

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False negative culture results in periprosthetic joint infection (PJI) are not uncommon particularly when patients have received long term antibiotics. Polymerase chain reaction (PCR) has a lower specificity partly due to detection of residual DNA from dead bacteria. Propidium monoazide (PMA) prevents DNA from dead bacteria from being amplified during the PCR. This study aimed to determine the role of PMA in PCR for diagnosis of PJI. Clinical samples were tested by PCR with and without prior treatment with PMA and compared to conventional microbiological culture. The PCR assay included genus-specific primers for staphylococci and enterococci and species-specific primers for Cutibacterium acnes. The validated conditions of PMA treatment used in this study were 20 μM concentration and 5 and 10 min of dark incubation and photo-activation respectively. 202 periprosthetic tissues and explanted prostheses from 60 episodes in 58 patients undergoing revision arthroplasties for either PJI or non-infective causes were tested, by culture, PCR, and PMA-PCR. 14 of the 60 episodes satisfied the Musculoskeletal Infection Society (MSIS) criteria for PJI and 46 did not. Sensitivity of culture, PCR, and PMA-PCR were 50%, 71%, and 79% respectively. Specificities were 98%, 72%, and 89% respectively. All figures were calculated for episodes rather than samples. PMA-PCR enhanced both the specificity and the sensitivity of PCR. It has the potential to detect residual bacterial viability prior to reimplantation in the two-stage revision for PJI.

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The effect of anticoagulants on venous thrombosis prevention after knee arthroscopy: a systematic review

Cited by 14 publications

References 33 publications

Symptomatic Deep Vein Thrombosis Following Elective Knee Arthroscopy Over the Age of 40

Symptomatic Deep Vein Thrombosis Following Elective Knee Arthroscopy Over the Age of 40

Effect of lower‐leg trauma and knee arthroscopy on procoagulant phospholipid‐dependent activity

Propidium monoazide–polymerase chain reaction for detection of residual periprosthetic joint infection in two-stage revision

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