著者 Sakata, Kenichiro| Furumatsu, Takayuki| Miyazawa, Shinichi| Okada, Yukimasa| Fujii, Masataka| Ozaki, Toshifumi|
発行日 2013-01
出版物タイトル International Orthopaedics
37巻
1号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/53910
フルテキストURL 69_6_355.pdf
著者 Okada, Yukimasa| Furumatsu, Takayuki| Miyazawa, Shinichi| Tanaka, Takaaki| Fujii, Masataka| Ozaki, Toshifumi| Abe, Nobuhiro|
抄録 Venous thromboembolism (VTE) is a potential complication occurring after total knee arthroplasty (TKA). We investigated the incidence of VTE after TKA using contrast-enhanced computed tomography (CT), and assessed the efficacy of VTE prophylaxis (fondaparinux and enoxaparin). At our hospital, 189 patients (225 knees) underwent TKA between April 2007 and October 2011. The 225 knees were divided into a control group with no VTE prophylaxis (31 cases), a fondaparinux group (107 cases), and an enoxaparin group (87 cases). Contrast-enhanced CT screening for VTE was performed in all cases on day 5 or 6 after TKA. D-dimer levels were measured on day 5 after TKA, and were significantly lower in the fondaparinux (9.8±3.8) and enoxaparin groups (9.4±4.9) than in the control group (15.6±9.8) (p<0.001). However, no statistically significant difference in the incidence of VTE was observed among the groups (control, 61.3%;fondaparinux, 49.5%;enoxaparin, 50.6%). Prophylaxis was not effective for the prevention of VTE as detected by contrast-enhanced CT after TKA. CT should be performed after TKA, even when VTE prophylaxis is used.
キーワード venous thromboembolism contrast-enhanced computed tomography total knee arthroplasty fondaparinux enoxaparin
Amo Type Original Article
発行日 2015-12
出版物タイトル Acta Medica Okayama
69巻
6号
出版者 Okayama University Medical School
開始ページ 355
終了ページ 359
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2015 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 26690246
Web of Sience KeyUT 000368434500005
JaLCDOI 10.18926/AMO/49259
フルテキストURL 67_1_65.pdf
著者 Sakata, Kenichiro| Furumatsu, Takayuki| Abe, Nobuhiro| Miyazawa, Shinichi| Sakoma, Yoshimasa| Ozaki, Toshifumi|
抄録 Bone marrow-stimulating techniques such as microfracture and subchondral drilling are valuable treatments for full-thickness cartilage defects. However, marrow stimulation-derived reparative tissues are not histologically well-documented in human osteoarthritis. We retrospectively investigated cartilage repairs after marrow stimulation for the treatment of large cartilage defects in osteoarthritic knees. Tissues were obtained from patients who underwent total knee arthroplasty (TKA) after arthroscopic marrow stimulation in medial compartmental osteoarthritis. Clinical findings and cartilage repair were assessed. Sections of medial femoral condyles were histologically investigated by safranin O staining and anti-type II collagen antibody. Marrow stimulation decreased the knee pain in the short term. However, varus leg alignment gradually progressed, and TKA conversions were required. The grade of cartilage repair was not improved. Marrow stimulations resulted in insufficient cartilage regeneration on medial femoral condyles. Safranin O-stained proteoglycans and type II collagen were observed in the deep zone of marrow-stimulated holes. This study demonstrated that marrow stimulation resulted in failed cartilage repair for the treatment of large cartilage defects in osteoarthritic knees. Our results suggest that arthroscopic marrow stimulation might not improve clinical symptoms for the long term in patients suffering large osteoarthritic cartilage defects.
キーワード bone marrow stimulation microfracture subchondral drilling osteoarthritis of the knee cartilage repair
Amo Type Case Report
発行日 2013-02
出版物タイトル Acta Medica Okayama
67巻
1号
出版者 Okayama University Medical School
開始ページ 65
終了ページ 74
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2013 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 23439511
Web of Sience KeyUT 000316829900009