Issue: 2016, Vol. 21, No. 2

Ryazantsev D. I., Prokhorova M. Yu., Chenskiy A. D., Petrov N. V., Kavalerskiy G. M., Zarov A. Yu., Katunyan P. I.

ENDOPROSTHESIS OF KNEE AND HIP JOINTS IN EARLY POSTOPERATIVE PERIOD IN ELDERLY PATIENTS: ANALYSIS OF THROMBOEMBOLIC COMPLICATIONS

Keywords

endoprosthesis, thrombosis, old age, knee joint, hip joint

Abstarct

Objective - to analyze the results of endoprosthesis of knee and hip joints in elderly patients in order to determine risk factors for thromboembolic complications in early postoperative period. Material and methods . 141 operations for endoprosthesis of knee joint (78) and hip joint (63) were performed in orthopedic unit of therapeutic rehabilitative centre from January to April 2014; (average age of patients was amounting to 67,4 years). Generally adopted complex of thrombosis prevention techniques was used. The authors developed their own technique for postoperative prophylaxis which included elastic bandage, compressive knitted wear, interrupted pneumatic compression, administration of nadroparin and cibor or rivaroxaban, muscle electromyostimulation. The duration of anticoagulants intake varied from 2 to 4 weeks. Blood thrombogenicity was examined in 14-16 hours after the operation. Ultrasound scanning of lower limbs was made on the next day after the operation.12 patients with thrombosis of superficial and deep veins of lower limbs in early postoperative period were enrolled into 1 group, 2 (control) group was composed of patients without thrombotic complications; they were selected from the 129 others at random. Results . Body mass and operation duration were statistically significant in the group of patients with thrombotic complications. The age of the patients and their hemorrhage magnitude did not have statistically significant differences. Level of fibrinogen and prothrombin, prothrombin time, INR and activated partial thromboplastin time did not differ statistically significant between the groups. Conclusions . The probability of thrombosis was in direct dependence on the duration of the operation and the patient body mass. Blood coagulability parameters and intraoperative hemorrhage magnitude did not reflect the risk of thrombosis in early postoperative period.

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