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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of preoperative normovolaemic haemodilution with dextran 70 in 57 patients undergoing total hip replacement for osteoarthritis, was evaluated with respect to the production of thrombosis and pulmonary embolism. The patients were randomly allocated to one group undergoing preoperative haemodilution and one control group receiving 500 ml dextran 70 during operation and again on the second postoperative day. Before operation blood was replaced by dextran 70 to lower the hematocrit to between 25 and 30. The blood drained from the patients was used to replace blood lost at operation. Between 10 and 14 days after operation the patients were examined by perfusion lung scan, chest radiography and bilateral phlebography. Twelve patients also had 133Xe ventilation scans. The incidence of deep vein thrombosis in the two groups did not differ significantly. Pulmonary embolism was significantly decreased in the preoperative haemodilution group. One patient in the control group had clinical symptoms of, and died from, pulmonary embolism.
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PMID:Preoperative normovolaemic haemodilution with dextran 70 as a thromboembolic prophylaxis in total in hip replacement. 52 86

Obesity, edema in the legs before surgery, a history of deep venous thrombosis, varicose veins, and a diagnosis of osteoarthrosis were associated with an increased risk for postoperative thromboembolism. Selective administration of anticoagulants to high risk but not to low risk patients should result in a reduction in total mortality following surgery. It is therefore suggested that when deciding whether prophylactic anticoagulants should be administered to a patient, consideration should be given to that patient's likelihood of developing fatal pulmonary embolism if the anticoagulant is not given, compared to the potential reduction in his risk for fatal pulmonary embolism and the increase in risk for fatal bleeding complications if the anticoagulant is used.
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PMID:Prediction of thromboembolism following total hip replacement. 126 Nov 18

Heparin-associated thrombocytopenia (HAT) type II, a severe side effect of heparin therapy, is thought to be induced by an immunological mechanism. By crossreactivity studies we have demonstrated that sera of patients with HAT type II activate platelets in vitro not only after the addition of heparin but also after addition of a chemically polysulphated chondroitin-like substance, Arteparon, used for treatment of degenerative joint disease. In addition here, we describe a patient who developed deep venous thrombosis and pulmonary embolism following administration of Arteparon and typical HAT type II with thrombocytopenia, 36 h after the first administration of heparin. This patient had never received heparin, but had repeatedly been treated with Arteparon for degenerative joint disease. We conclude that this patient had been presensitized by Arteparon, as indicated by his clinical course. In vitro studies again confirm crossreactivity between heparin and Arteparon.
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PMID:Heparin-associated thrombocytopenia in a patient treated with polysulphated chondroitin sulphate: evidence for immunological crossreactivity between heparin and polysulphated glycosaminoglycan. 138 26

Hip surgery is the most common major orthopedic procedure performed in the elderly. The indications are fracture and pain secondary to degenerative arthritis. Patients undergoing hip replacement for arthritis have excellent outcomes with decreased pain, increased mobility, and a low mortality. Age should not be a contraindication to hip replacement, with patient selection being made on the basis of symptomatology and overall health. In hip fracture, the prognosis is more guarded. Poor functional outcome results from complications of the fracture, such as avascular necrosis of the femoral head and fracture nonunion in femoral neck fractures and instability with delayed weight bearing in intertrochanteric fractures. In addition, patients sustaining hip fracture are more likely to have significant comorbidity and subsequent perioperative complications. Pressure ulcers, delirium, deep venous thrombosis, urinary retention and urinary tract infection, and cardiac events are the most frequent complications seen. These complications can be anticipated and prevented with careful preoperative assessment and post-operative prophylactic management. A team approach including the orthopedic surgeon, primary care physician, nursing staff, and physical therapists is essential for optimal outcome.
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PMID:Surgical management of the hip in the elderly patient. 219 20

A series of 43 hips (41 patients) in which a cemented revision arthroplasty was performed for a symptomatic, nonseptic, loose (42) or broken (1) femoral component was reviewed clinically and radiographically. The operation was done using femoral components of contemporary design, a trochanteric osteotomy, a cement gun, and a PMMA femoral plug. The femoral compactor and water pic were used once they became available (36%). The average follow-up period was 74 months (range, 60-111 months). The primary diagnoses included osteoarthritis (52%), CDH (32%), posttraumatic arthritis (6%), AVN (6%), and SCFE (4%). The average age of the patients at the time of the operation that failed was 52.2 years and at revision was 57.4 years. Only one revised cemented femoral component (2% of hips) required rerevision surgery for septic loosening. The average postoperative Harris hip score was 87 points. Four hips (9%) were classified radiographically as definitely loose, one (2%) as probably loose, and one (2%) as possibly loose, but all of these patients had a good or excellent clinical rating. Complications included deep venous thrombosis in 16 patients, trochanteric nonunion in 3 hips, femoral shaft perforations in eight hips, and postoperative dislocations in 6 hips. These techniques appear to represent an improvement over prior techniques.
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PMID:Revision of nonseptic, loose, cemented femoral components using modern cementing techniques. 318 78

We report a rare case of degenerative joint disease of both knees, complicated by a Baker cyst. Our emphasis is on the role of electromyography and electrodiagnosis in the localization of this nerve entrapment syndrome. The patient presented with pain and swelling; venography revealed deep venous thrombosis of the right calf, including the popliteal and proximal superficial femoral vessels. The patient responded well to bed rest, analgesics, intravenous heparin and subsequent Coumadin anticoagulation, and was discharged two weeks later. Five weeks after onset of these acute problems, nerve conduction studies were done, leading to a diagnosis of Baker cyst with nerve entrapment. He responded well to knee joint aspiration and intraarticular prednisolone injection. Some evidence of improvement in the flexor hallicus longus muscle was detected at three-month follow-up.
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PMID:Tibial nerve entrapment by a Baker cyst: case report. 396 70

In the first 1000 arthroscopic operations performed by one surgeon 136 patients had two or more procedures, making a total of 1168 during the 1000 operations. The indications for operation were internal mechanical derangements in 565 patients, anterior knee pain in 246, disorders of the synovium in 77, ligament injuries in 63, and degenerative joint disease in 49. Complications included fracture of instruments in the knee in five patients, haemarthrosis in 10, deep vein thrombosis in three, and synovial fistula in one. In no patient was the wound infected. A total of 26 different operations was performed.
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PMID:Arthroscopic surgery of the knee. 681 32

Patients with rheumatoid arthritis (RA) and osteoarthritis (OA) were compared for the incidence of deep venous thrombosis (DVT) after total hip replacement (THR). RA patients after total knee replacement (TKR) were also compared for the incidence of DVT. The relative risk of OA patients developing DVT after THR was 2.3 times that of RA patients. In RA patients after TKR, the chance of DVT was 4.8 times greater than after THR, implying that added stress in knee surgery can overcome the inherent protection RA patients may have. Although salicylates may be protective, firm conclusions regarding the effect of drugs, including corticosteroids on the development of DVT could not be made.
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PMID:Is there a lower incidence of deep venous thrombosis after joint replacement in rheumatoid arthritis? 742 Mar 38

The authors discuss the results of 81 total knee arthroplasties in 65 patients performed between April 1987 and April 1989 using a Tricon hybrid system, consisting of the Tricon M bio-ingrowth femoral prosthesis and the Tricon C cemented tibial component. The Tricon metal-backed patella was used until February 29, 1988, when the all-plastic Tricon C patella was introduced. With an average follow up of 24 months (range: 12 to 48), 38 arthroplasties using this hybrid system were rated as excellent (47%) and 38 were rated as good (47%). The Hospital for Special Surgery scores, which averaged 53 preoperatively, averaged 80 at the most recent follow-up assessment. At the most recent follow-up assessment, 79% of osteoarthritis patients and 56% of rheumatoid arthritis patients have no pain at rest, while 19% of osteoarthritis patients and 44% of rheumatoid arthritis patients have mild pain at rest. Sixty-four percent of osteoarthritis patients and 33% of rheumatoid arthritis patients have no pain while walking, whereas 26% of osteoarthritis patients and 56% of rheumatoid arthritis patients have mild pain while walking. Postoperative complications included fragmentation of the patella in five patients, all occurring with the metal-backed patella. Five patients also experienced petellar subluxation (two metal-backed and three all-polyethylene). One patient had deep venous thrombosis which was treated successfully by re-hospitalization and heparin therapy; one patient with chronic heart disease expired 4 days postoperatively. Use of the Tricon hybrid system has resulted in 94% of all patients having a good or excellent result an average of 24 months postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Tricon hybrid total knee arthroplasty: a review of 81 knees followed for 2 to 4 years. 760 18

In 124 patients with osteoarthritis 152 knee arthroplasties were evaluated with a mean follow-up of 7 years (range 5.2-9.1 years). Forty-six patients (53 knees) were either dead or otherwise lost to follow-up. Thus, 99 knee arthroplasties were evaluated. Three arthroplasties had been revised. Of the remaining 96 knee arthroplasties, 95% had achieved a satisfactory result. Five arthroplasties were unacceptable. One had a poor result and four a fair result. The reason for the poor/fair results was in one case a loose patellar component and in one case malposition of the components and ligament insufficiency. In 54.2% of the arthroplasties, there were radiolucent lines beneath the tibial component. There was one fatal pulmonary embolism, and four knees with superficial wound infection. One of these probably went on to late loosening. There was one case of peroneal nerve palsy. Three cases of deep vein thrombosis were diagnosed.
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PMID:The total condylar knee prosthesis in osteoarthritis. A 5- to 10-year follow-up. 818 49


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