Deep venous thrombosis (DVT) is a potentially serious complication after total hip (THA) and knee (TKA) arthroplasty, traditionally justifying aggressive prophylaxis with low molecular weight heparin (LMWH) or direct oral anticoagulants (DOA) at the cost of an increased risk of bleeding. However, fast-track procedures might reduce the DVT risk and decrease the cost-benefit ratio of the current recommendations. The objective of this study was to compare thrombotic and bleeding risk in an unselected population of elective THA and TKA with a fast-track procedure. A series of 1,949 patients were analyzed prospectively. There were 1,136 women and 813 men, with a mean age of 70 years. In particular, 16% were previously treated by antiplatelet agents and 8% by anticoagulants. All patients followed a fast-track procedure including early walking within 24 hours of surgery, and 80% of patients returned home after surgery, with a mean length of stay of 3 days (THA) or 4 days (TKA). The occurrence of a thromboembolic event or hemorrhagic complication has been identified.Introduction
MATERIAL - METHODS
External rotation of the femoral component is one factor that favors a satisfactory clinical result. New technologies have been developed to precisely implant the components of a total knee arthroplasty, including computer-assisted surgery (CAS) and patient-specific instruments (PSIs). The aim of this study was to compare the precision of CAS and PSIs when determining the orientation of the femoral component. A total of 65 patients operated on in 2008 with CAS had pre- and post-operative computed tomography (CT) in which the posterior condylar angle (PCA) was measured. The same pre- and post-operative measurements were performed for 27 patients operated on in 2010 with the assistance of PSI. For both populations, the antero-posterior femoral cuts were directed to implant the femoral component 3° of external rotation from the pre-operative posterior condylar line (PCL).Purpose
Methods
