The use of factor Xa inhibitors following opening-wedge high tibial osteotomy for venous thromboembolism prophylaxis

Kobayashi, Hideo; Akamatsu, Yasushi; Kumagai, Ken; Kusayama, Yoshihiro; Ishigatsubo, Ryo; Mitsuhashi, Shota; Kobayashi, Akihiro; Aratake, Masato; Saito, T.

doi:10.1007/s00167-016-4065-6

Cited by 12 publications

(15 citation statements)

References 31 publications

(50 reference statements)

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“…Although there are several studies regarding the incidence of VTE following TKA, 5,7,9,25 few studies have reported the incidence of VTE following HTO (►Table 6). 10,26,27 Some studies reported the incidence of VTE after lateral closed-wedge HTO (LCWHTO) in the Western population, which is higher than that observed in our study. It suggested that the prevalence of overall VTE after HTO was lower in Asians than in Westerners.…”

Section: Discussioncontrasting

confidence: 75%

Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?

Kim

Lee

et al. 2020

J Knee Surg

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The aim of this study was to investigate the overall incidence of venous thromboembolism (VTE) and to assess the efficacy of chemoprophylaxis to prevent VTE following medial open-wedge high tibial osteotomy (MOWHTO) in Asian patients. A total of 133 patients who consecutively underwent MOWHTO for the treatment of knee osteoarthritis with varus deformity were enrolled. All patients underwent preoperative ultrasonography and computed tomography venography on postoperative day 5 to detect deep vein thrombosis (DVT). Patients were divided into two groups: chemoprophylaxis group included patients (n = 66) who received 2.5 mg fondaparinux for 5 days postoperatively, whereas control group comprised patients (n = 67) who received placebo (67 patients). We evaluated the efficacy and safety outcomes of the treatment. We also assessed the predisposing factors that may affect the occurrence of VTE. The incidence of overall DVT was 14.9% in the control group and 10.6% in the chemoprophylaxis group (p > 0.05). Proximal DVT occurred in one patient in the control group. There was no symptomatic DVT or pulmonary embolism in either group. The patients with DVT had significantly higher mean body mass index (BMI) than the patients without DVT. Multivariate logistic regression showed BMI > 30 kg/m2 that was significantly correlated with the development of DVT (odds ratio = 0.8; p = 0.017). There were no cases of major bleeding; however, minor bleeding episodes occurred in four patients in the chemoprophylaxis group. The current study showed that the overall incidence of VTE following MOWHTO was low in Asian patients even without chemoprophylaxis. Therefore, routine chemoprophylaxis following MOWHTO seems to be not necessary in a population with low-VTE incidence. However, selective chemoprophylaxis should be considered in patients with BMI > 30 kg/m2.

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Section: Discussioncontrasting

confidence: 75%

Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?

Kim

Lee

et al. 2020

J Knee Surg

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“…It has a sensitivity of 78% and specificity of 72% at a cut-off value of 53.5 ng/mL (Normal range 2.5 – 80 ng/mL). The area under the curve (AUC) on a receiver operating curve (ROC) range from 0.79 - 0.84 942,945,950,955,963,977,982 .…”

Section: - Are There Any Serological Biomarkers For the Diagnosis Of ...mentioning

confidence: 99%

“…It has a sensitivity ranging from 71% - 79% and a specificity of 27% - 41%. The AUC on a ROC is 0.82 944,945,950,959,960,966,981 .…”

Section: - Are There Any Serological Biomarkers For the Diagnosis Of ...mentioning

confidence: 99%

Recommendations from the ICM-VTE: General

2022

Journal of Bone and Joint Surgery

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“…The incidence of pulmonary embolism (PE), as reported in three of the five studies. Sidhu et al, report a rate of 0.5%, Giuseffi et al, a rate of 1.1% and Kobayashi et al, reported PE rate of 6.3% in the edoxaban group and 16.7% in the non-edoxaban group 322,323,326 . None of the studies reported any VTE related complications such as death, bleeding, or others.…”

Section: - Is Routine Vte Prophylaxis Needed For Patients Undergoing ...mentioning

confidence: 97%

“…Kobayashi et al, performed a randomized controlled trial investigating DVT rates via venography following tibial osteotomy. The edoxaban (a factor Xa inhibitor) treated group had a rate of 16.7% compared to the non-edoxaban rate of 21.7% 326 . The incidence of pulmonary embolism (PE), as reported in three of the five studies.…”

Section: - Is Routine Vte Prophylaxis Needed For Patients Undergoing ...mentioning

confidence: 99%

Recommendations from the ICM-VTE: Trauma

2022

Journal of Bone and Joint Surgery

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The ICM-VTE Trauma Delegates* 1 -What is the most optimal VTE prophylaxis in patients with multiple orthopaedic injuries?Response/Recommendation: Although multiple forms of prophylaxis against venous thromboembolism (VTE) with variable effectiveness are available for patients with multiple orthopedic injuries, low-molecular-weight heparin (LMWH) is considered the most optimal choice based on available literature.Strength of Recommendation: Acceptable.Delegates vote: Agree 86.36% Disagree 9.09% Abstain 4.55% (Strong Consensus).Rationale: VTE events following multiple orthopaedic injuries are associated with significant morbidity and mortality 1,2 . The prevalence of deep venous thrombosis (DVT) in trauma patients without prophylactic treatment can reach up to 60%. Pulmonary embolism (PE) can be a fatal form of VTE with prevalence ranging between 2 -16% 3,4 . VTE can be prevented using different mechanical and chemical prophylaxis agents, therefore, significantly lower the burden on healthcare systems worldwide 1 . The aim of this review is to find the most optimal VTE prophylaxis in patients with multiple orthopaedic injuries.Multiple orthopaedic injuries rarely happen without extraskeletal injuries, therefore, no studies in the current literature addressed VTE prophylaxis in patients with multiple orthopaedic injuries but without extra-skeletal injuries. Most of the available literature is addressing this patient population under different groups including, patients with trauma, poly-trauma, high energy fractures and lower extremity injuries [1][2][3][5][6][7] . The level of evidence varies among the reviewed literature, however, randomized controlled clinical trials in this subject are limited 3,4 .Based on our review, LMWH is considered the most optimal VTE prophylaxis in patients with multiple orthopaedic injuries 1,3,5,6,[8][9][10][11][12][13][14] . Ley et al., recommends using LMWH due to its increased bioavailability, acceptably low bleeding complications and longer plasma half-life 1 . Rogers et al., published in their guidelines for prevention of VTE in trauma patients that LMWH has superior bioavailability when compared to lowdose heparin (LDH) 5 . Knudson et al., concluded in a prospective, randomized trial that LMWH is an extremely effective *A list of the ICM-VTE Trauma Delegates is included in a note at the end of the article. Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJS/G855).

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The use of factor Xa inhibitors following opening-wedge high tibial osteotomy for venous thromboembolism prophylaxis

Abstract: I.

Cited by 12 publications

References 31 publications

Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?

Do We Need Chemoprophylaxis to Prevent Venous Thromboembolism following Medial Open-Wedge High Tibial Osteotomy?

Recommendations from the ICM-VTE: General

Recommendations from the ICM-VTE: Trauma

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