Venous thromboembolism (VTE), including pulmonary embolism (PE) resulting from deep vein thrombosis (DVT), remains a well-known serious complication after femoral fractures. The low molecular heparin is widely used to prevent VTE. This study compared the effectiveness of VTE prevention between dalteparin and enoxaparin. From 2013 to 2014, we retrospectively recruited 712 patients who had femoral fractures with operative treatment. All patients receiving VTE chemoprophylaxis with perioperative period using dalateparin in Group 1(N=395) and enoxaparin in Group 2(N=317). The prophylactic dosing was determined using individual product labeling and identified as enoxaparin 40 mg every 12 hours and dalteparin 2500 international unit (IU) once daily, based on clinical practice guidelines. The prophylaxis was started at admission, and maintained during average 8.43.5 days after operation. The outcome including the incidence of clinically significant deep vein thrombosis, pulmonary embolism, perioperative bleeding and cost of drugs were evaluated between two groups.Introduction
Materials and Methods
Although thigh pain is an annoying problem after total hip arthroplasty (THA), little information has been known about its natural course. To determine the frequency, time of onset, and duration of thigh pain after cementless THA, we evaluated 240 patients (240 hips) who underwent primary THA because of femoral head osteonecrosis with the use of a single tapered stem.Background
Methods
Arthroplasties of hip and knee are associated with blood loss, which may lead to adverse patient outcome. Jehovah's Witnesses do not accept blood transfusion. Performing arthroplasties in Witness patients without transfusion has been a matter of concern. We developed a protocol, which avoids transfusion in arthroplasties of Witness patients, and evaluated the feasibility and safety of the protocol. Our protocol consisted of subcutaneous administration of 4000 U recombinant erythropoietin and 100 mg of intravenous iron supplements when patient's hemoglobin level was less than 10 g/dL in preoperative evaluation. During the operation, cell saver, and plasma expander were used. Postoperatively, recombinant erythropoietin was administered three times a week and iron supplements were administered daily until the hemoglobin level reached 10 g/dL. We evaluated the feasibility of our protocol, perioperative complications and hematologic changes.Introduction
Materials and Methods
In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty(BH), compression hip screw(CHS) and proximal femur nail antirotatory(PFNA) in treating comminuted intertrochanteric fractures(AO type, A2(21, 22, 23)) We retrospectively evaluated total 150 patients(BH:50, CHS:50, PFNA: 50) who were operated due to intertrochanteric fractures from March 2010 to Dec 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris hip score, ability of ambulation(Koval stage), visual analogue scale and radiologic limb length discrepancy(shortening). Landmark and radiologic length was checked.
–A: postoperative length –A’: POD 1year –B: immediate posteopative contralateral length(from hip center to distal tip of lesser trochanter) –B’: POD 1year contralateral length(from hip center to distal tip of lesser trochanter) –
Limb length(shortening) was adjusted considering difference of magnification = {A × (B’/B)}− A’Introduction
Materials and Methods
Two-stage reconstruction, reimplantation after removal of an infected prosthesis, has been considered to be the gold standard for treatment of infected hip arthroplasty. However, during the removal of a well-fixed femoral stem, the proximal femur can be damaged and a sequestrum can be formed, which might lead to chronic osteomyelitis and difficulty in reimplantation. We wanted to determine whether infection after hip arthroplasty can be treated without removal of a well-fixed stem. We treated 19 patients who had an infection after hip replacement, but a well-fixed cementless stem, with 2-stage reconstruction. At the first stage, we removed the acetabular cup, the liner and the head, but not the stem. We then implanted a cup of cement spacer. After control of infection, we reimplanted the acetabular component and head.Background:
Materials and Methods:
