ABSTRACT
OBJECTIVES: We investigated risk factors for venous thromboembolism (VTE), prophylaxis measures employed, and incidence of symptomatic deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major orthopaedic surgery (MOS). METHODS: An open, multicenter, prospective, observational study was conducted in 21 medical centers, comprising 899 patients. Of these, 316 patients (35.2%) underwent total hip arthroplasty (THA), 328 patients (36.5%) underwent total knee arthroplasty (TKA), and 255 patients (28.4%) underwent surgery for hip fractures (HF). Pharmacologic prophylaxis was employed in all the patients. RESULTS: Risk factors for VTE were seen in 73.2% of the patients, the most common being obesity (72%) and prolonged immobilization (36.3%). Low-molecular-weight heparin (91.1%) and fondaparinux (8.9%) were used for prophylaxis, which was short-term in 273 patients (30.4%) and long-term in 626 patients (69.6%). Mechanical prophylaxis was performed with compression stockings in 610 patients (67.9%) and by intermittent pneumatic compression in 67 patients (7.5%). During three-months of follow-up, symptomatic DVT and PE were seen in eight (0.9%) and four patients (0.4%), respectively. Mortality occurred in 10 patients (1.1%). Complications of major and minor bleeding were seen in eight (0.9%) and 40 (4.5%) patients, respectively. CONCLUSION: Effective VTE prophylaxis is associated with low risk of clinically apparent DVT and PE in MOS.
Subject(s)
Anticoagulants/therapeutic use , Orthopedic Procedures/adverse effects , Pulmonary Embolism/prevention & control , Venous Thromboembolism/prevention & control , Aged , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Knee/adverse effects , Female , Fondaparinux , Heparin, Low-Molecular-Weight/therapeutic use , Hip Fractures/surgery , Humans , Immobilization/adverse effects , Male , Middle Aged , Obesity/complications , Polysaccharides/therapeutic use , Prospective Studies , Pulmonary Embolism/epidemiology , Pulmonary Embolism/mortality , Risk Factors , Venous Thromboembolism/epidemiology , Venous Thromboembolism/mortalityABSTRACT
Hydatid diseases of the bone and muscles are rare, generally are incurable, and have a high level of recurrence. We attempted to ascertain whether the recurrence rate decreased in patients with hydatid disease infestation of the bone and skeletal muscle who were treated with current surgical techniques and antihelminthic chemotherapy, and whether the outcomes for bone infestation were different when compared with outcomes for muscular infestation. We retrospectively reviewed 15 patients with hydatid disease of the bone (eight patients) and muscle (seven patients). The average followup was 30 months (range, 6-69 months). Recurrence was observed in four patients with bone involvement. No patient with muscle involvement had a recurrence after excision. Hydatid disease of the bone often is recurrent and progressive despite using advanced diagnostic studies, improved surgical techniques, and newly developed antihelminthic drugs. The disease status also was not as good as for patients with bone lesions when compared with patients with muscular lesions.
Subject(s)
Bone Diseases/surgery , Echinococcosis/surgery , Muscular Diseases/surgery , Adult , Aged , Antinematodal Agents/therapeutic use , Bone Diseases/diagnostic imaging , Bone Diseases/drug therapy , Chemotherapy, Adjuvant , Child , Echinococcosis/diagnostic imaging , Echinococcosis/drug therapy , Female , Follow-Up Studies , Humans , Male , Mebendazole/therapeutic use , Middle Aged , Muscular Diseases/diagnostic imaging , Muscular Diseases/drug therapy , Outcome and Process Assessment, Health Care , Prognosis , Radiography , Recurrence , Treatment OutcomeABSTRACT
Percutaneous autogeneic bone marrow injection is an effective method for managing simple bone cysts, and it might be considered before the application of more extensive procedures.
