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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 104 - 104
1 Jul 2012
Hoare C Harper-Smith H Ashman O Skyrme A Rajaratnam S Armitage A
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Introduction

This study investigates the effect of Rivaroxaban (Bayer HealthCare) on early post-operative stiffness in primary total knee replacement.

Methods

The anticoagulant of choice for total knee arthroplasty in our Department was changed from Enoxaparin to Rivaroxaban in September 2009. We reviewed a consecutive, multi-surgeon, multi-implant series of primary total knee replacements for a 6 month period prior to (group A) and after (group B) the treatment change. All patients were reviewed by an independent Clinical Specialist Physiotherapist at 6 weeks post-surgery, where the range of movement was recorded prospectively using a goniometer. A stiff knee replacement was defined as one with 15 degrees of extension deficit or flexion to less than 75 degrees at 6 week follow up. All data was analysed on an intention to treat basis.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 60 - 60
1 Jul 2012
Colaço H Davidson J Pekicten B Ahmed S Skyrme A Armitage A Rajaratnam S
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Purpose

This study investigates the effect of early tourniquet release on range of flexion following total knee replacement, and the influence of anticoagulation with Rivaroxaban and Clexane (Enoxaparin).

Method

78 patients were included in the study, who underwent unilateral primary total knee replacement (TKR) in our department under the care of two specialist knee surgeons over a 12 month period. 27 patients underwent TKR with early release of the tourniquet and haemostasis, prior to closure of quadriceps layer: 22 were anticoagulated with Rivaroxaban (GROUP ER), 15 with the low molecular weight heparin Clexane (GROUP EC). Over the same time period, 41 patients TKR with late release of the tourniquet, following closure and bandaging: 13 were anticoagulated with Rivaroxaban (GROUP LR), 28 with Clexane (GROUP LC). A standardised operative technique was employed, and all patients received an AGC (Biomet) PCL-retaining prostheses. Outcome was assessed with range of flexion at 12 weeks postoperatively.


The Journal of Bone & Joint Surgery British Volume
Vol. 88-B, Issue 3 | Pages 321 - 323
1 Mar 2006
Papavasiliou AV Isaac DL Marimuthu R Skyrme A Armitage A

We reviewed 231 patients who had undergone total knee replacement with an AGC (Biomet) implant over a period of 2.5 years. After applying exclusion criteria and with some loss to follow-up, there were 144 patients available for study. These were divided into two groups; those who had received intra-articular steroid in the 11 months before surgery and those who had not.

There were three deep infections, all of which occurred in patients who had received a steroid injection. The incidence of superficial infection was not significantly different in the two groups. Five patients had undergone investigation for suspected deep infection because of persistent swelling or pain and all of these had received an intra-articular injection pre-operatively. We conclude that the decision to administer intra-articular steroids to a patient who may be a candidate for total knee replacement should not be taken lightly because of a risk of post-operative deep infection.