Post-operative Bleeding, Thromboembolic Events
Conditions
Keywords
Knee Replacement, Total, Hip Replacement, Total, Thromboembolism, Venous, prophylaxis, Enhanced recovery
Brief summary
There are many different views regarding ideal duration and type of thromboprophylaxis after hip or knee surgery. An important factor in Fast-track surgery is early mobilization, which in itself is thought to prevent clotting. The investigators hypothesize that there is no increase with regards to thrombosis in patients receiving fast-track surgery with early mobilization and chemical thrombosis prophylaxis only during hospitalization.
Detailed description
Major orthopaedic surgery is related to development of thrombosis. It is well known that pharmacological prophylaxis reduces the risk of thrombosis after surgery but there are still doubt about the best type of prophylaxis and duration of treatment. The American College of Chest Physicians recommend thromboprophylaxis with either Low molecular weight heparin, factor Xa-inhibitors or Vitamin-K-antagonists for up til 10 days after total knee replacement (TKR) and 35 days after total hip replacement(THR). However whether these recommendations are applicable in fast-track patients receiving early mobilisation is uncertain. Studies on fast-track patients receiving early mobilisation and thrombosis prophylaxis only during hospitalisation showed very small incidence of symptomatic thromboembolic events. Therefore we conduct a quality-cohort-study on all patients receiving fast-track TKR/THR with short-term anti-thrombotic treatment, in order to investigate frequency of symptomatical deep vein thrombosis, pulmonary embolus, acute myocardial infarction and stroke.
Interventions
None listed
Sponsors
Rigshospitalet, Denmark
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* primary Uni/bilateral THR/TKR, revision THR/TKR or uni-KR in fast-track setup, Discharged in 3 +-2 days.
Exclusion criteria
* not a danish citizen
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frequency of Vascular events | 90 days postop | Frequency of symptomatic deep venous thrombosis, pulmonary embolus, acute myocardial infarction, ischemic stroke and other vascular events and/or death |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Risk factors of vascular events | 90days postop | Assessment of preoperative risk factors, and their influence on risk of vascular events after hip and knee arthroplasty |
Other
| Measure | Time frame | Description |
|---|---|---|
| bleeding events after total hip or knee arthroplasty | 2 days after last dose of prophylaxis | Assessment of any major bleeding events possibly related to thrombosis prophylaxis after surgery |
Countries
Denmark
Outcome results
None listed