Influence of bone density in the thromboembolic complications after total knee endoprosthesis replacement

Written by Vahrushev N.А., Eliseeva Е.V., Goncharova R.K.

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Background. Nowadays there is no data on the effect of bone density on the incidence of venous thrombo-embolism after total knee endoprosthesis replacement. Methods. The study involved 80 patients who underwent total knee endoprosthesis replacement. Condi-tion of bone mineral density was studied by dual energy x-ray absorptiometry of the proximal femur and lumbar spine. Given the importance of T-score patients were divided into two groups: the 1st – 40 patients with T-score not lower –2,5 SD, 2nd – 40 patients with T-score of less than –2,5 SD. Veins condition of the lower limbs was assessed using Doppler ultrasound. D-dimer levels were used as a laboratory marker of thrombus. Results. There was a significant increase in the concentration of D-dimer in the 7th postoperative day, more pronounced in the 2nd group. The differences between the values of the group maintained during 6 months. 6 months later, after surgery venous thrombosis of the lower limbs was diagnosed in 2.5 % of patients in group 1 and 7.5 % of patients in group 2. Conclusions. An interconnection was detected between the increased incidence of venous thrombosis and decreased bone mineral density in patients with osteoarthritis of the knee joint after total endoprosthesis replacement. There is a necessity of further studying of the characteristics of thrombosis in patients with osteoporosis after operations on the joints.

Links to authors:

N.А. Vahrushev, Е.V. Eliseeva, R.K. Goncharova
Pacific State Medical University (2 Ostryakova Ave. Vladivostok 690950 Russian Federation)

1. Brylyakova S.N. Indicators of bone metabolism and hemostasis in elderly patients suffering from involutional osteoporosis in combination with coronary heart disease: thesis abstract, PhD. Samara, 2005. 23 p.
2. Savelev V.S., Chazov E.I., Gusev E.I. [et al.] Russian clinical recommendations for diagnosis, treatment and prevention of venous thromboembolic events // Phlebology. 2010. No. 1 (2). P. 5–6.
3. Skripnikova I.A. Interconnection of cardiovascular disease due to atherosclerosis, and generalized osteoporosis in postmenopausal women: thesis of MD. М., 2008. 208 p.
4. Khitrov N.A. The structure of the incidence of osteoarthritis and the problem of the presence of comorbidities // Ter. archive 2005. No. 12. P. 59–63.
5. Breart G., Cooper C., Meyer O. [et al.] Osteoporosis and venous thromboembolism: a retrospective cohort study in the UK General Practice Research Database // Osteoporosis International. 2010. Vol. 21, No. 7. P. 1181–1187.
6. Cimmino M.A., Sarzi-Puttini P., Scarpa R. [et al.] Clinical presentation of osteoarthritis in general practice: determinants of pain in Italian patients in the AMICA Study // Semin. Arthritis Rheum. 2005. Vol. 35. P. 17–23
7. Falck-Ytter Y., Francis C.W., Johanson N.A. American College of Chest Physicians. Prevention of VTE in orthopedic surgery patients: antithrombotic therapy and prevention of thrombosis, 9th ed. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines // Chest. 2012. Vol. 141 (2 Suppl.). P. 278S–325S.
8. Guyatt G.H., Akl E.A., Crowther M. [et al.] American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines // Chest. 2012. Vol. 141 (2 Suppl). P. 7S–47S.
9. Maetzel A., Li L.C., Pencharz J. [et al.] The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study // Ann. Rheum. Dis. 2004. Vol. 63, No. 4. P. 395–401.
10. Mantilla C.B., Horlocker T.T., Schroeder D.R. [et al.] Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty // Anesthesiology. 2002. Vol. 96, No. 5. P. 1140–1146
11. Migita K., Bito S., Nakamura M. [et al.] Venous thromboembolism aftertotal joint arthroplasty: results from a Japanese multicenter cohort study // Arthritis Res. Ther. 2014. Vol. 16, No. 4. P. R154.
12. Murphy L., Helmick C.G. The impact of osteoarthritis in the United States: a population-health perspective // Am. J. Nurs. 2012. Vol. 112 (3 Suppl. 1). P. S13–S19.
13. Parvizi J., Huang R., Raphael I.J. [et al.] Symptomatic pulmonary embolus after joint arthroplasty: stratification of risk factors // Clin. Orthop. Relat. Res. 2014. Vol. 472, No. 3. P. 903–912.
14. Rizzoli R., Akesson K., Bouxsein M., Kanis J.A. Subtrochanteric fractures after long-term treatment with bisphosphonates: a European society on clinical and economic aspects of osteoporosis and osteoarthritis, and International osteoporosis foundation working group report // Osteoporos. Int. 2011. Vol. 22, No. 2. P. 373–390
15. Terracciano C., Celi M., Lecce D., Baldi J. Differential features of muscle fiber atrophy in osteoporosis and osteoarthritis // Osteoporos. Int. 2012. Vol. 26, No. 4. P. 175–179.


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