Saratov JOURNAL of Medical and Scientific Research
Home

Thrombinogenesis in patients with aseptic instability of knee endoprosthesis and periprosthetic infection

Year: 2020, volume 16 Issue: №2 Pages: 478-484
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Girkalo M.V., Shakhmartova S.G., Shpinyak S.P., Mandrov A.V., Kozadaev M.N., Puchinyan D.M.
Organization: Saratov State Medical University
Summary:

Objective: To evaluate thrombinogenesis in patients with periprosthetic infection and aseptic loosening of endoprosthesis after primary knee arthroplasty. Material and Methods: 28 of 52 examined patients who suffered from the loosening of knee endoprosthesis components and 24 from periprosthetic infection; 18 healthy individuals were also engaged into the study. Thrombinogenesis was analyzed with thrombin generation assay in an automated Ceveron alpha coagulometer (Technoclone, Austria) using RB and RC-low activators containing 2 and 5 pmol/ml of tissue factor respectively. Each of the main groups of patients was divided into two subgroups: in patients of the 1st subgroups RC-low activator aggravate thrombinogenesis while in the 2nd subgroups it inhibited the process as compared to the effects of RB activator. Results: In the 1st subgroup of patients with aseptic loosening RC-low activator caused chronometric hyperthrombinogenesis, and in the 2nd — both chronometric and structural ones. In patients with periprosthetic infection the effects of RB and RC-low activators were comparable. Conclusion: In patients with aseptic loosening of the implant and stopped periprosthetic infection that developed after primary knee replacement, the thrombin generation test reveals normal, paradoxical and inert types of thrombinogenesis.

Keywords: aseptic instability, knee replacement, periprosthetic infection, thrombin generation test, thrombogenesis

Bibliography:
1. Kurtz S, Ong K, Lau E, et al. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89 (4): 780-5. DOI: 10.2106/JBJS. F. 00222.
2. Bourne RB, Chesworth BM, Davis AM, et al. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res 2010; (468): 57-63. DOI: 10.1007/sl 1999-009-1119-9.
3. Vielgut I, Kastner N, Pichler K, et al. Application and surgical technique of total knee arthroplasties: a systematic comparative analysis using worldwide registers. International Orthopaedics 2013; 37: 1465-9. DOI: 10.1007/s00264-013-1933-2.
4. Tay KS, Lo NN, Yeo SJ, et al. Revision total knee arthroplasty: causes and outcomes. Ann Acad Med Singapore, 2013; 42 (4): 178-83.
5. Lieberman JR, Pensak MJ. Prevention of venous thromboembolic disease after total hip and knee arthroplasty. J Bone Joint Surg Am 2013; 95 (19): 1801-11. DOI: 10.2106/JBJS. L. 01328.
6. Lee S, Hwang Jl, Kim Y, et al. Venous thromboembolism following hip and knee replacement arthroplasty in Korea: A nationwide study based on claims registry. J Korean Med Sci 2016; 31 (1):80-8. DOI: 10.3346/jkms. 2016.31.1.80.
7. Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications (VTEO). Phlebology 2015; 2 (4): 2-51.
8. Idestrup С, Sawhney М, Nix С, et al. The incidence of hematoma formation in patients with continuous femoral catheters following total knee arthroplasty while receiving rivaroxaban as thromboprophylaxis: an observational study. Reg Anesth Pain Med 2014; 39 (5): 414-17. DOI: 10.1097/AAP 0000000000000127.
9. Kang Y, Zhang ZJ, Fu M, et al. Blood transfusion and drainage catheter clamping are associated with haematoma formation at the surgical site after total knee arthroplasty: an analysis of 102 unilateral cases. Eur J Orthop Surg Traumatol 2013; 23 (2): 219-24. DOI: 10.1007/s00590-012-0958-3.
10. Liu XH, Fu PL, Wang SYe, et al. The effect of drainage tube on bleeding and prognosis after total knee arthroplasty: a prospective cohort study. J Orthop Surg Res 2014; (9): 27. DOI: 10.1186/1749-799X-9-27.
11. Esler CN, Blakeway C, Fiddian NJ. The use of a closed-suction drain in total knee arthroplasty. A prospective, randomised study. J Bone Joint Surg Br2003; 85 (2): 215-17.
12. Fan Y, Liu Y, Lin J, et al. Drainage does not promote postoperative rehabilitation after bilateral total knee arthroplasties compared with nondrainage. Chin Med Sci J 2013; 28 (4): 206-10. DOI: 10.1016/s1001-9294(14) 60003-1.
13. Li B, Wen Y, Wu H, et al. The effect of tourniquet use on hidden blood loss in total knee arthroplasty. Int Orthop 2009; 33 (5): 1263-8. DOI: 10.1007/s00264-008-0647-3.
14. Zou Y, Tian S, Wang Y, et al. Administering aspirin, rivaroxaban and low-molecular-weight heparin to prevent deep venous thrombosis after total knee arthroplasty. Blood Coagul Fibrinolysis 2014; 25 (7): 660-4. DOI: 10.1097/MBC. 0000000000000121.
15. Li B, Wen Y, Liu D, Tian L. The effect of knee position on blood loss and range of motion following total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2012; 20 (3): 594-9. DOI: 10.1007/S00167-011 -1628-4.
16. Ma T, Khan RJ, Carey Smith R, et al. Effect of flexion/extension splintage post total knee arthroplasty on blood loss and range of motion — a randomised controlled trial. Knee 2008; 15 (1): 15-9. DOI: 10.1016/j. knee. 2007.09.004.
17. Ning L, Simin L, Cheanglek H, et al. Changes in coagulation functions and hemorheological parameters may predict hematoma formation after total knee arthroplasty. Journal of Orthopaedic Surgery and Research 2016; (11): 35. DOI: 10.1186/s13018-016-0370-5.
18. Luna-Zajzar H, Gonzalez-Moncada Al, Padilla-Lopez EL, et al. Thrombin generation and international normalized ratio in inherited thrombophilia patients receiving thromboprophylactic therapy. Thromb Res 2015; 136 (6): 1291-8. DOI: 10.1016/j. thromres. 2015.10.026.
19. Puchinyan DM, Shakhmartova SV, Vorobyova IS. Thrombin generation test in the assessment of the adaptation possibilities of the hemocoagulation system in patients with degenerative-distrophic diseases of joints. Thrombosis, Hemostasis and Rheology 2019; (4): 39-46.
20. Espitia О, Fouassier М. Thrombin generation test. Rev Med Interne 2015; 36 (10): 690-3. DOI: 10.1016/j. revmed. 2015.04.013.

AttachmentSize
2020_02_478-484.pdf358.6 KB
All articles of the authors: Girkalo M.V., Kozadayev M.N. , Mandrov A.V., Puchinyan D.M. , Shakhmartova S.G. , Shpinyak S.P.

No votes yet