Abstract
Background: Recent advances in the understanding of blood coagulation processes favor an inflammatory basis for thrombotic events. In this study, thrombotic risk after total knee arthroplasty (TKA) was assessed and compared between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA). Methods: Subjects comprised 199 patients (238 knees) with RA and 156 patients (169 knees) with OA. Serum D-dimer levels were measured before and after the operation. Lowdose unfractionated heparin was given for 7 days when patients had a history of previous venous thromboembolism or had a D-dimer level or ≥10 μg/ml of D-dimer on postoperative day 1. Doppler ultrasonography (DUS) was routinely performed preoperatively and on postoperative day (POD) 7 for diagnosing a deep venous thrombosis (DVT). Results: D-dimer levels on PODs 0, 1, and 7 were, respectively, 4.6, 37.2, and 11.2 μg/ml for RA and 1.8, 42.3, and 13.6 μg/ml for OA. The incidence of DUS-confirmed DVT was 20.6% in the RA group and 43.2% in the OA group, indicating a much higher incidence of postoperative DVT in OA patients (P < 0.001). Interestingly, when patients taking nonsteroidal antiinflammatory drugs (NSAIDs) or those >65 years of age were excluded, the incidence of DVT was comparable in the RA and OA groups. Symptomatic pulmonary embolism and DVT occurred in two and one OA patients and in one and two RA patients, respectively, with one postdischarge DVT included in each group. Conclusions: The present study revealed that the incidence of DVT following TKA was significantly lower in RA patients than in those with OA. However, when the patients were matched for age and NSAID use, the incidence of DVT was equivalent in the two groups. These findings may allow us to reconsider a prophylactic regimen for venous thromboembolism in patients with RA.
| Original language | English |
|---|---|
| Pages (from-to) | 57-63 |
| Number of pages | 7 |
| Journal | Journal of Orthopaedic Science |
| Volume | 15 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2010 Jan |
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ASJC Scopus subject areas
- Orthopedics and Sports Medicine
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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.
In: Journal of Orthopaedic Science, Vol. 15, No. 1, 01.2010, p. 57-63.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Rheumatoid arthritis
T2 - A risk factor for deep venous thrombosis after total knee arthroplasty? Comparative study with osteoarthritis
AU - Niki, Yasuo
AU - Matsumoto, Hideo
AU - Hakozaki, Akihiro
AU - Mochizuki, Takeshi
AU - Momohara, Shigeki
PY - 2010/1
Y1 - 2010/1
N2 - Background: Recent advances in the understanding of blood coagulation processes favor an inflammatory basis for thrombotic events. In this study, thrombotic risk after total knee arthroplasty (TKA) was assessed and compared between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA). Methods: Subjects comprised 199 patients (238 knees) with RA and 156 patients (169 knees) with OA. Serum D-dimer levels were measured before and after the operation. Lowdose unfractionated heparin was given for 7 days when patients had a history of previous venous thromboembolism or had a D-dimer level or ≥10 μg/ml of D-dimer on postoperative day 1. Doppler ultrasonography (DUS) was routinely performed preoperatively and on postoperative day (POD) 7 for diagnosing a deep venous thrombosis (DVT). Results: D-dimer levels on PODs 0, 1, and 7 were, respectively, 4.6, 37.2, and 11.2 μg/ml for RA and 1.8, 42.3, and 13.6 μg/ml for OA. The incidence of DUS-confirmed DVT was 20.6% in the RA group and 43.2% in the OA group, indicating a much higher incidence of postoperative DVT in OA patients (P < 0.001). Interestingly, when patients taking nonsteroidal antiinflammatory drugs (NSAIDs) or those >65 years of age were excluded, the incidence of DVT was comparable in the RA and OA groups. Symptomatic pulmonary embolism and DVT occurred in two and one OA patients and in one and two RA patients, respectively, with one postdischarge DVT included in each group. Conclusions: The present study revealed that the incidence of DVT following TKA was significantly lower in RA patients than in those with OA. However, when the patients were matched for age and NSAID use, the incidence of DVT was equivalent in the two groups. These findings may allow us to reconsider a prophylactic regimen for venous thromboembolism in patients with RA.
AB - Background: Recent advances in the understanding of blood coagulation processes favor an inflammatory basis for thrombotic events. In this study, thrombotic risk after total knee arthroplasty (TKA) was assessed and compared between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA). Methods: Subjects comprised 199 patients (238 knees) with RA and 156 patients (169 knees) with OA. Serum D-dimer levels were measured before and after the operation. Lowdose unfractionated heparin was given for 7 days when patients had a history of previous venous thromboembolism or had a D-dimer level or ≥10 μg/ml of D-dimer on postoperative day 1. Doppler ultrasonography (DUS) was routinely performed preoperatively and on postoperative day (POD) 7 for diagnosing a deep venous thrombosis (DVT). Results: D-dimer levels on PODs 0, 1, and 7 were, respectively, 4.6, 37.2, and 11.2 μg/ml for RA and 1.8, 42.3, and 13.6 μg/ml for OA. The incidence of DUS-confirmed DVT was 20.6% in the RA group and 43.2% in the OA group, indicating a much higher incidence of postoperative DVT in OA patients (P < 0.001). Interestingly, when patients taking nonsteroidal antiinflammatory drugs (NSAIDs) or those >65 years of age were excluded, the incidence of DVT was comparable in the RA and OA groups. Symptomatic pulmonary embolism and DVT occurred in two and one OA patients and in one and two RA patients, respectively, with one postdischarge DVT included in each group. Conclusions: The present study revealed that the incidence of DVT following TKA was significantly lower in RA patients than in those with OA. However, when the patients were matched for age and NSAID use, the incidence of DVT was equivalent in the two groups. These findings may allow us to reconsider a prophylactic regimen for venous thromboembolism in patients with RA.
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UR - http://www.scopus.com/inward/citedby.url?scp=77249108019&partnerID=8YFLogxK
U2 - 10.1007/s00776-009-1410-3
DO - 10.1007/s00776-009-1410-3
M3 - Article
C2 - 20151252
AN - SCOPUS:77249108019
VL - 15
SP - 57
EP - 63
JO - Journal of Orthopaedic Science
JF - Journal of Orthopaedic Science
SN - 0949-2658
IS - 1
ER -