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There are many different views regarding ideal duration and type of thromboprophylaxis after hip or knee surgery.
An important factor in Fast-track surgery is early mobilization, which in itself is thought to prevent clotting.
The investigators hypothesize that there is no increase with regards to thrombosis in patients receiving fast-track surgery with early mobilization and chemical thrombosis prophylaxis only during hospitalization.
Major orthopaedic surgery is related to development of thrombosis. It is well known that pharmacological prophylaxis reduces the risk of thrombosis after surgery but there are still doubt about the best type of prophylaxis and duration of treatment. The American College of Chest Physicians recommend thromboprophylaxis with either Low molecular weight heparin, factor Xa-inhibitors or Vitamin-K-antagonists for up til 10 days after total knee replacement (TKR) and 35 days after total hip replacement(THR). However whether these recommendations are applicable in fast-track patients receiving early mobilisation is uncertain.
Studies on fast-track patients receiving early mobilisation and thrombosis prophylaxis only during hospitalisation showed very small incidence of symptomatic thromboembolic events. Therefore we conduct a quality-cohort-study on all patients receiving fast-track TKR/THR with short-term anti-thrombotic treatment, in order to investigate frequency of symptomatical deep vein thrombosis, pulmonary embolus, acute myocardial infarction and stroke.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| THR/TKR patients | Any patients receiving fast-track THR or TKR in departments participating in the Lundbeck Foundation Centre for fast-track THR and TKR |
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| Measure | Description | Time Frame |
|---|---|---|
| Frequency of Vascular events | Frequency of symptomatic deep venous thrombosis, pulmonary embolus, acute myocardial infarction, ischemic stroke and other vascular events and/or death | 90 days postop |
| Measure | Description | Time Frame |
|---|---|---|
| Risk factors of vascular events | Assessment of preoperative risk factors, and their influence on risk of vascular events after hip and knee arthroplasty | 90days postop |
| Measure | Description | Time Frame |
|---|---|---|
| bleeding events after total hip or knee arthroplasty | Assessment of any major bleeding events possibly related to thrombosis prophylaxis after surgery | 2 days after last dose of prophylaxis |
Inclusion Criteria:
Exclusion Criteria:
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Any patient receiving elective fast-track THR or TKR
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| Name | Affiliation | Role |
|---|---|---|
| Christoffer C Joergensen, MD | Section of surgical pathophysiology, 4074, Rigshospitalet, Copenhagen University, Copenhagen. | Principal Investigator |
| Henrik Kehlet, Professor | Section of surgical pathophysiology, 4074 Rigshospitalet, Copenhagen University | Study Chair |
| Kjeld Soeballe, Professor | Aarhus University hospital, Orthopaedic department E | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Aarhus University hospital | Aarhus | Judland | 8000 | Denmark | ||
| Farsoe Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33485092 | Background | Petersen PB, Lindberg-Larsen M, Jorgensen CC, Kehlet H; Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty collaborating group. Venous thromboembolism after fast-track elective revision hip and knee arthroplasty - A multicentre cohort study of 2814 unselected consecutive procedures. Thromb Res. 2021 Mar;199:101-105. doi: 10.1016/j.thromres.2021.01.003. Epub 2021 Jan 18. | |
| 32673960 |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Mar 23, 2012 | Jan 25, 2021 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D013923 | Thromboembolism |
| D054556 | Venous Thromboembolism |
| ID | Term |
|---|---|
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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| Farsø |
| Judland |
| 9640 |
| Denmark |
| Sydvestjydsk Sygehus | Grindsted | Judland | 7200 | Denmark |
| Holstebro Hospital | Holstebro | Judland | 7500 | Denmark |
| Vejle hospital | Vejle | Judland | Vejle | Denmark |
| Hvidovre University hospital | Hvidovre | Region Sjælland | 2650 | Denmark |
| Background |
| Petersen PB, Jorgensen CC, Gromov K, Kehlet H; Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group. Venous thromboembolism after fast-track unicompartmental knee arthroplasty - A prospective multicentre cohort study of 3927 procedures. Thromb Res. 2020 Nov;195:81-86. doi: 10.1016/j.thromres.2020.07.002. Epub 2020 Jul 4. |
| 31587249 | Background | Petersen PB, Jorgensen CC, Kehlet H; Lundbeck Foundation Centre for Fast-track Hip Knee Replacement Collaborative Group. Venous Thromboembolism despite Ongoing Prophylaxis after Fast-Track Hip and Knee Arthroplasty: A Prospective Multicenter Study of 34,397 Procedures. Thromb Haemost. 2019 Nov;119(11):1877-1885. doi: 10.1055/s-0039-1696686. Epub 2019 Oct 6. |
| 30453352 | Background | Petersen PB, Kehlet H, Jorgensen CC; Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group. Safety of In-Hospital Only Thromboprophylaxis after Fast-Track Total Hip and Knee Arthroplasty: A Prospective Follow-Up Study in 17,582 Procedures. Thromb Haemost. 2018 Dec;118(12):2152-2161. doi: 10.1055/s-0038-1675641. Epub 2018 Nov 19. |
| 26826506 | Background | Jorgensen CC, Kehlet H; Lundbeck Foundation Centre for Fast-track Hip and Knee replacement collaborative group. Early thromboembolic events </=1week after fast-track total hip and knee arthroplasty. Thromb Res. 2016 Feb;138:37-42. doi: 10.1016/j.thromres.2015.12.025. Epub 2015 Dec 29. |
| 24334158 | Background | Jorgensen CC, Jacobsen MK, Soeballe K, Hansen TB, Husted H, Kjaersgaard-Andersen P, Hansen LT, Laursen MB, Kehlet H. Thromboprophylaxis only during hospitalisation in fast-track hip and knee arthroplasty, a prospective cohort study. BMJ Open. 2013 Dec 10;3(12):e003965. doi: 10.1136/bmjopen-2013-003965. |