Abstract
IntroductionThe number of total hip and total knee replacement procedures performed worldwide has tended to surge in recent years, due to the combination of such factors as the increased life expectancy, improved quality of life, advances in medical technology as well as pre-operative and post-operative patient management.Numerous studies confirm that patients undergoing major orthopaedics procedures involving lower extremities, for instance total hip and total knee replacement, constitute the highest risk group for the development of post-operative venous thromboembolism (VTE), primarily manifested as deep vein thrombosis (DVT).PurposeThe purpose of the research was to assess the dynamics of D-dimer level fluctuation during the post-operative period in patients after the cemented or cementless total hip replacement (THR) or total knee replacement (TKR), in order to prove or reject the thesis that the cemented and cementless THR or TKR affects the post-operative D-dimer levels.Material and methodsThe study group consisted of 47 patients aged 29–82 years. Of them, 23 had the cementless THR, 12 subjects had the cemented THR and another 12 patients had the TKR. All of the patients performed to measure the concentration of D-dimers in the peri-operative period at predetermined time points. For the peri-operative period was adopted from time 1 day before surgery to 10-day hospitalization. The subarachnoid block (SAB) was performed in all patients.ResultsThe distribution of D-dimer values throughout the entire post-operative period (up to 10th post-operative day) followed the sinusoid pattern with two peaks in all patients. It was not specific in any group.ConclusionsThe D-dimer level almost doubles during the post-operative period in patients after THR or TKR.Higher level of D-dimers in post-operative period in the research group of patients does not relate to higher risk of thromboembolic disease.
Highlights
The number of total hip and total knee replacement procedures performed worldwide has tended to surge in recent years, due to the combination of such factors as the increased life expectancy, improved quality of life, advances in medical technology as well as pre-operative and post-operative patient management
1. The D-dimer level almost doubles during the post-operative period in patients after total hip replacement (THR) or total knee replacement (TKR). 2
Higher level of D-dimers in post-operative period in the research group of patients does not relate to higher risk of thromboembolic disease
Summary
The number of total hip and total knee replacement procedures performed worldwide has tended to surge in recent years, due to the combination of such factors as the increased life expectancy, improved quality of life, advances in medical technology as well as pre-operative and post-operative patient management. Numerous studies confirm that patients undergoing major orthopaedics procedures involving lower extremities, for instance total hip and total knee replacement, constitute the highest risk group for the development of post-operative venous thromboembolism (VTE), primarily manifested as deep vein thrombosis (DVT). D-dimers are fibrin degradation products formed as a result of fibrin clot dissolution by plasmin They participate in the entire homeostasis mechanism including coagulation and fibrinolysis processes. After the thrombus is dissolved by plasmin, the fibrin degradation products such as D-dimers are released Their elevated plasma concentration indicates that the coagulation and fibrinolysis mechanisms were triggered. D-dimer level measurement is not included in the routine pre-operative laboratory panel This test is typically done in patients with suspected venous thromboembolism (VTE), manifested as deep vein thrombosis (DVT) or pulmonary embolism (PE) [1]. It implies that while deep vein thrombosis is the primary manifestation of the disease, pulmonary embolism may follow as the sequelae
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