The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88^th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)

ISSN 1005-8478

CN 37-1247/R

Abstact:

Objective

To explore the dynamic changes of hypercoagulability after primary total hip/knee arthroplasty (THA/TKA) , and potential risk factors during prophylactic anti-coagulation therapy for setting up proper perioperative management.

Methods

From August 2015 to May 2017, this prospective study enrolled patients who underwent primary THA/TKA. Thromboelastogram (TEG) and platelet count were evaluated preoperatively, at 1, 4 and 7 days postoperatively. Variation trends of the parameters were analyzed.

Results

Based on the including and excluding criteria, 100 patients were entered into this study, including 50 patients who received TKA, while the other 50 patients who had THA. The normal TEG parameters were noted preoperatively in all of them. Compared with those before operation, the R value declined to the minimum at 4 days postoperatively, while the K value kept steady decline until 7 days after surgery, moreover, the peak of a-angle and MA value increased to the maximum at 7 days postoperatively, with statistically significant differences (P ＜0.001) . No differences of reactive hypercoagulability after surgery were found between the TKA and THA, although significant differences in hypercoagulability were noted among the time points, including that preoperatively, at 1, 4 and 7 days postoperatively. According to TEG monitoring,  the hypercoagulability kept rising in the first 7 days after surgery. The hypercoagulability varied with increased proportion of  the platelet type and the mixed type over time.

Conclude

With dynamic TEG monitoring during perioperative period, discrepancies of blood coagulation status in different patient at different time point do be revealed. Therefore, monitoring and individualized regulation of anti-coagulation are necessary.