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Bone & Joint 360
Vol. 11, Issue 5 | Pages 46 - 47
1 Oct 2022
Das A


Bone & Joint 360
Vol. 10, Issue 6 | Pages 48 - 50
1 Dec 2021
Evans JT French JMR Whitehouse MR


Bone & Joint 360
Vol. 9, Issue 5 | Pages 49 - 50
1 Oct 2020
Das MA


Bone & Joint 360
Vol. 6, Issue 5 | Pages 39 - 40
1 Oct 2017
Das A


Bone & Joint Research
Vol. 2, Issue 3 | Pages 58 - 65
1 Mar 2013
Johnson R Jameson SS Sanders RD Sargant NJ Muller SD Meek RMD Reed MR

Objectives

To review the current best surgical practice and detail a multi-disciplinary approach that could further reduce joint replacement infection.

Methods

Review of relevant literature indexed in PubMed.


The Journal of Bone & Joint Surgery British Volume
Vol. 90-B, Issue 3 | Pages 388 - 392
1 Mar 2008
Virchenko O Aspenberg P Lindahl TL

Thrombin has many biological properties similar to those of growth factors. In a previous study, we showed that thrombin improves healing of the rat tendo Achillis. Low molecular weight heparin (LMWH) inhibits the activity and the generation of thrombin. We therefore considered that LMWH at a thromboprophylactic dose might inhibit tendon repair. Transection of the tendo Achillis was carried out in 86 rats and the healing tested mechanically. Low molecular weight heparin (dalateparin) was either injected a few minutes before the operation and then given continuously with an osmotic mini pump for seven days, or given as one injection before the operation. In another experiment ,we gave LMWH or a placebo by injection twice daily. The anti-factor Xa activity was analysed. Continuous treatment with LMWH impaired tendon healing. After seven days, this treatment caused a 33% reduction in force at failure, a 20% reduction in stiffness and a 67% reduction in energy uptake. However, if injected twice daily, LMWH had no effect on tendon healing. Anti-factor Xa activity was increased by LMWH treatment, but was normal between intermittent injections. Low molecular weight heparin delays tendon repair if given continuously, but not if injected intermittently, probably because the anti-factor Xa activity between injections returns to normal, allowing sufficient thrombin stimulation for repair. These findings indicate the need for caution in the assessment of long-acting thrombin and factor Xa inhibitors