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Thromboelastography in elective total hip arthroplasty
- Source :
- World Journal of Orthopedics
- Publication Year :
- 2021
- Publisher :
- Baishideng Publishing Group Inc., 2021.
-
Abstract
- BACKGROUND: Hypercoagulability plays an important role in predisposing patients to venous thromboembolism (VTE) after total hip arthroplasty (THA). We used thromboelastography (TEG) to examine the coagulation status of patients undergoing THA. AIM: To examine coagulation as measured by TEG in patients undergoing THA who received standard VTE chemoprophylaxis with enoxaparin. METHODS: After ethical approval, we performed a retrospective analysis of data collected in patients undergoing primary elective THA. We analyzed TEG data on samples performed before skin incision, intraoperatively and for 5 d postoperatively. Conventional coagulation tests were performed preoperatively and on postoperative day 5. RESULTS: Twenty patients undergoing general anesthesia and 32 patients undergoing spinal anesthesia (SA) were included. TEG demonstrated a progressively hypercoagulable state postoperatively, characterized by elevated maximum amplitude. TEG also demonstrated transient intraoperative hypercoagulability in patients receiving SA. In contrast, conventional coagulation tests were normal in all patients, pre- and postoperatively, except for an increase in plasma fibrinogen day 5 postoperatively. CONCLUSION: Despite VTE prophylaxis, patients following total hip replacement remain in a hypercoagulable state as measured by both TEG and conventional tests. This group may benefit from more optimal anticoagulation and/or additional perioperative hemostatic monitoring, via TEG or otherwise.
- Subjects :
- Bupivacaine
medicine.medical_specialty
medicine.diagnostic_test
business.industry
Observational Study
Orthopedic
Perioperative
Fibrinogen
medicine.disease
Thromboelastography
Thrombelastography
Surgery
Pulmonary embolism
Hypercoagulability
Orthopedic surgery
Chemoprophylaxis
medicine
Coagulation testing
Hip arthroplasty
Anesthesia
Orthopedics and Sports Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 22185836
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- World Journal of Orthopedics
- Accession number :
- edsair.doi.dedup.....01786930f700f13bee2dc9c31e84e0e4