Thrombotic events in patients underwent simultaneous bilateral total knee arthroplasty with modern perioperative blood management strategy.

Autor: Tsukada S; Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, 310-0035, Ibaraki, Japan. s8058@nms.ac.jp., Saito M; Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, 310-0035, Ibaraki, Japan., Ogawa H; Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, 310-0035, Ibaraki, Japan., Nishino M; Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, 310-0035, Ibaraki, Japan., Hirasawa N; Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, 310-0035, Ibaraki, Japan.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 Dec 02; Vol. 145 (1), pp. 2. Date of Electronic Publication: 2024 Dec 02.
DOI: 10.1007/s00402-024-05624-8
Abstrakt: Background: Thrombotic events, the leading cause of death after total knee arthroplasty (TKA), occurred more frequently in simultaneous bilateral TKA than unilateral TKA under conventional perioperative management. The aim of the study was to determine whether the simultaneous bilateral TKA using contemporary blood management strategies would be associated with higher risk of thrombotic events than unilateral TKA.
Method: This propensity score-matched cohort study included 1,069 patients, with 324 undergoing simultaneous bilateral TKA and 745 undergoing unilateral TKA. All TKAs were performed without use of a tourniquet and with use of intravenous tranexamic acid administration. For patients receiving chronic antithrombotic therapy, the antithrombotic medications were continued during the perioperative period, including on the day of the operation. The primary outcome was the thrombotic events up to 1 year after TKA.
Results: The propensity score-matched cohort consisted of 324 matched pairs of patients. There was no significant difference between simultaneous bilateral and unilateral TKA groups in the occurrence of the thrombotic events (25 of 324 [7.7%] versus 19 of 324 [5.9%] patients, p = 0.44). Additionally, no significant differences were found in the occurrence of the bleeding events (1 of 324 [0.3%] versus 1 of 324 [0.3%] patients, p > 0.99) and death within the postoperative 1 year (1 of 324 [0.3%] versus 3 of 324 [0.9%] patients, p = 0.62).
Conclusion: The rate of thrombotic events after simultaneous bilateral TKA with contemporary perioperative blood management strategies did not significantly differ from that after unilateral TKA.
Competing Interests: Declarations. Ethical approval: The study was initiated after receiving approval from the institutional review board. Informed consent: Informed consent was obtained both for participation and publication in the form of opt-out on the web-site, and those who rejected were excluded. Conflict of interest: One of the authors (S.T.) certifies receipt of personal payments during the study period, in an amount of less than USD 10,000 from Stryker Japan and Zimmer-Biomet Japan.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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