Abstract:
INTRODUCTION:Prevention of venous thromboembolism (VTE) generally consists of low molecular weight heparin (LMWH) or direct oral anticoagulants (DOACs) after total hip arthroplasty (THA) or total knee arthroplasty (TKA). Enhanced recovery after surgery (ERAS) protocols may reduce the VTE risk after these procedures. The aim of this study was to compare the risk of VTE and the risk of bleeding complications in a non-selected population of primary THA and TKA cases done within an ERAS protocol. HYPOTHESIS:The risk of postoperative VTE after primary THA and TKA is lower than the risk of bleeding complications within an ERAS protocol. METHODS:This was a prospective observational study conducted on a national scale in France. All patients who underwent primary unilateral THA or TKA at one of 11 participating hospitals between October 2016 and October 2017 were enrolled and followed for 3 months. The occurrence of a VTE or major bleeding event was recorded. No patients were lost to follow-up at 3 months. RESULTS:Of the 1110 THA cases, there were 5 VTE (0.4%) and 19 bleeding events (1.7%). Of the 893 TKA cases, there were 9 VTE (1.0%) and 14 bleeding events (1.7%). There was no significant difference in the VTE incidence and bleeding event incidence after THA and TKA. The overall incidence of bleeding complications (1.7%) was significantly greater than the overall incidence of VTE complications (0.7%) (p=0.005). This was the case after THA (p=0.004) but not after TKA. DISCUSSION:The primary finding of this study is that bleeding complications are significantly more common than VTE complications after THA or TKA within an ERAS protocol. Based on these findings, the cost-benefit ratio of antithrombotic prophylaxis by LMWH or DOACs in this context should be reassessed. LEVEL OF EVIDENCE:IV; Prospective cohort study without control group.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Jenny JY,Bulaid Y,Boisrenoult P,Bonin N,Henky P,Tracol P,Chouteau J,Courtin C,Henry MP,Schwartz C,Mertl P,De Ladoucette A,French Society of Orthopaedic Surgery, Traumatology (SofCOT).doi
10.1016/j.otsr.2020.02.026subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1533-1538issue
8issn
1877-0568pii
S1877-0568(20)30282-6journal_volume
106pub_type
杂志文章abstract:INTRODUCTION:Cemented versions of dual-mobility cups (DMCs), helpful in cases of bone stock alteration, are usually used in association with a reinforcement device. To simplify the intervention in elderly subjects or those with a poor bone stock, the cups can be cemented directly into the bone, but the long-term result...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.09.027
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:This study aimed to compare the clinical, radiological, aesthetic and economic outcomes of extension pin block technique and extension orthosis in closed mallet fractures with more than 1/3 of articular surface involvement without subluxation (Wehbe and Schneider classification type IB and IC). MATERIALS AND M...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.102764
更新日期:2020-12-23 00:00:00
abstract::Schwannomas are peripheral nerve sheath tumors. Schwannomas arising in the sciatic nerve are considered a rare condition. Their symptomatology usually mimics sciatic pain due to a herniated disc, which can delay the diagnosis. We report the case of a patient with chronic sciatica in whom Magnetic Resonance Imaging (MR...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.05.007
更新日期:2009-11-01 00:00:00
abstract::The problem of friction couples remains unresolved to this day. Improvements in femoral and acetabulum implant anchorage over the last 20 years have significantly extended total hip replacement (THR) implant lifespan; the formation of wear debris, however, leads to resorption and osteolysis, considerably shortening im...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.04.003
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:Implant fixation assessment following Vancouver B1 periprosthetic hip fracture is a major decision factor for internal fixation and/or implant revision. The main aim of the present study was to assess the correlation between radiographic Remaining Attachment Index (RAI) and risk of implant loosening at las...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.06.016
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Abundant anatomic descriptions exist of the posterior cruciate ligament (PCL) and menisco-femoral ligaments (MFLs). There is broad agreement that the PCL is composed of two bundles and inserts on the femur near the distal cartilage. However, a different configuration with a single bundle and a complex femora...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.102788
更新日期:2020-12-14 00:00:00
abstract:INTRODUCTION:Treatment of open tibial shaft fracture is controversial due to the risk of infection. We assessed results in a continuous series of open tibial shaft fractures treated by primary intramedullary nailing. HYPOTHESIS:Factors can be determined for non-union and onset of infection following primary intramedul...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.04.020
更新日期:2019-09-01 00:00:00
abstract:INTRODUCTION:All-inside posteromedial suture for lesions of the posterior horn of the medial meniscus in anterior cruciate ligament (ACL) repair provides effective freshening and good healing. HYPOTHESIS:The posteromedial portal provides satisfactory healing rates without increasing morbidity or complications rates. ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.08.008
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:Dystonia in extensor hallucis and/or digitorum muscles can be observed in pyramidal and extrapyramidal lesions and results in pain in these toes, spontaneous or when walking, problems and discomfort when putting on shoes and socks, and cutaneous lesions on the toes. The objective of this study was to asses...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2015.01.006
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate long-term radio-clinical outcome in scapulothoracic fusion using the Letournel technique (where the fourth rib is passed through the wing of the scapula and cerclage wires are tightened to the two ribs below) for patients suffering from facioscapulohumeral muscular dystr...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.12.012
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Personal and social factors may account for much of the variation in patient reported outcome scores, yet little evidence exists on how psychological properties affect patient outcomes following reverse total shoulder arthroplasty (rTSA). The objective of this study is to determine if resilience, characteris...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.102777
更新日期:2020-12-13 00:00:00
abstract:BACKGROUND:Acute Achilles tendon rupture can be treated conservatively or surgically. Open surgery restores tendon continuity but carries a risk of skin complications. Tenolig(®) is a device designed for the percutaneous biological treatment of acute Achilles tendon rupture. Earlier studies found high rates of recurren...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.09.018
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:In young active patients with hip dysplasia, choosing between periacetabular osteotomy (PAO) and total hip arthroplasty (THA) is challenging. MATERIALS AND METHODS:We systematically searched Medline, Embase, and Cochrane Library for studies published until October 10, 2019, comparing PAO and THA in patients...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2020.08.012
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Musculotendinous infraspinatus ruptures belong to the category of "muscle strain injuries". They differ from a classic rotator cuff tear by the following features: tendon attachment remains intact and the acute initial stage typically undergoes an intense muscular edema, replaced, 6 to 12 months later, by co...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.06.004
更新日期:2009-11-01 00:00:00
abstract:INTRODUCTION:Lumbar fusion is now a currently accepted treatment for degenerative lumbar spondylolisthesis (DLSP), but may induce adjacent segment degeneration (ASD). The present study hypothesis was that there are radiological parameters associated with ASD. The study objective was to determine predictive factors of A...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.03.012
更新日期:2016-10-01 00:00:00
abstract::Capitate fractures are rare and dislocations are even more uncommon. To our knowledge, there has been no report of a Capitate fracture with complete dislocation in the literature. Here, we present the first case of a Capitate fracture-dislocation, sustained after a motorcycle accident. ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.12.023
更新日期:2017-05-01 00:00:00
abstract::Although total hip arthroplasty is now a classic procedure that is well controlled by orthopedic surgeons, some cases remain complex. Difficulties may be due to co-morbidities: obesity, skin problems, muscular problems, a history of neurological disease or associated morphological bone deformities. Obese patients must...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2012.11.008
更新日期:2013-02-01 00:00:00
abstract:INTRODUCTION:Adipose tumors are the most common soft tissue tumor in adults; however, their epidemiology and histology in the hand and wrist are not well-defined. The aim of this study was to describe the histology and treatment strategy for this type of tumor at a specialized cancer center. HYPOTHESIS:The frequency o...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.12.011
更新日期:2020-04-01 00:00:00
abstract::We report a case of anterior thigh compartment syndrome (TCS), which occurred after a closed femoral fracture internal fixation using an intramedullary rod. A 20 ml ropivacaine hydrochloride single-injection femoral block had preceded general anaesthesia to conduct the surgical procedure. The compartment syndrome diag...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2009.03.014
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:Acute quadriceps tendon rupture is rare. The gold-standard repair technique is transosseous patellar suture. Biomechanical studies have validated the use of anchors as an alternative. The present study sought to report long-term clinical and radiological results in a series of acute quadriceps tendon ruptu...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.02.013
更新日期:2017-06-01 00:00:00
abstract::In the treatment of unstable pelvic ring fractures, external fixators have the limitation of not adequately stabilizing the injured posterior elements. This article presents a novel and simple technique of temporary external fixation of the pelvic ring, able to produce compression of both the anterior and posterior pe...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.09.013
更新日期:2016-12-01 00:00:00
abstract::The talonavicular (TN) joint and the three subtalar (ST) joints are linked anatomically and functionally. Together they form the subtalar joint complex, where movement occurs between the calcaneopedal unit (CPU) (entire foot except the talus) and the talotibiofibular unit (talus held tightly by the ankle mortise). Man...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2013.07.003
更新日期:2013-10-01 00:00:00
abstract:PURPOSE:To clarify the relationship between whole body sagittal radiographic parameters and health related quality of life (HRQOL) in patients with spinal disease, and further analyse such relationship based on the pelvic incidence (PI) value. METHODS:100 patients (mean age: 64.4 years, M/F=50/50) with lumbar degenera...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.07.009
更新日期:2018-11-01 00:00:00
abstract:INTRODUCTION:A number of techniques have been described in the management of thoracolumbar spinal fractures, testimony to the absence of consensus on their treatment. For the past few years, minimally invasive techniques have been developed to limit surgery-related iatrogenic injury. The objective of this study was to ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.03.020
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:The optimal approach for the fixation of coronoid process fractures is unknown. We present the advantages and the clinical effect of the pronator teres and the flexor carpi radialis interval approach for the treatment of ulna coronoid process fractures. METHODS:The patients, who had operative treatment of c...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.04.004
更新日期:2020-05-14 00:00:00
abstract::Children are physiologically protected against venous thromboembolism (VTE). Specific triggering events or contributing factors have been identified in the majority of reported cases, which differs from the adult pathology where 50% of the thromboses are considered "idiopathic". This is a rare disease in children with...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2019.05.026
更新日期:2020-02-01 00:00:00
abstract::Extensor tendon rupture is a rare but serious complication after total knee arthroplasty (TKA) that impairs active knee extension, thereby severely affecting knee function. Surgery is usually required. Surgical options range from simple suturing to allograft reconstruction of the entire extensor mechanism and include ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2015.06.025
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Tibial plateau fractures are notoriously difficult to manage, particularly when there is a medial or posteromedial component. We report a retrospective analysis of our experience with consecutive tibial plateau fractures including a medial component that were managed using a single lateral locking plate. HY...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.10.009
更新日期:2012-04-01 00:00:00
abstract::A prospective multi-centre nationwide study of patients with congenital dislocation of the hip (CDH) diagnosed after 3 months of age was conducted with support from the French Society for Paediatric Orthopaedics (Société Française d'Orthopédie Pédiatrique [SoFOP]), French Organisation for Outpatient Paediatrics (Assoc...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究,评审
doi:10.1016/j.otsr.2014.08.001
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:There is some debate over the best treatment for anterior-superior iliac spine (ASIS) avulsion fractures, although non-surgical treatment can achieve the same results as open surgery. HYPOTHESIS:Absorbable screws can be safely used for ASIS avulsion fractures in children and adolescents. AIM OF THE STUDY...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.02.014
更新日期:2020-11-01 00:00:00