warfarin and Osteoarthritis--Hip

Topics: Arthroplasty, Replacement, Hip; Humans; Knee Joint; Osteoarthritis, Hip; Osteoarthritis, Knee; Warfarin

Topics: Arthroplasty, Replacement, Hip; Humans; Knee Joint; Osteoarthritis; Osteoarthritis, Hip; Osteoarthritis, Knee; Warfarin

Topics: Arthroplasty, Replacement, Hip; Humans; Knee Joint; Osteoarthritis, Hip; Osteoarthritis, Knee; Warfarin

Topics: Arthroplasty, Replacement, Hip; Humans; Knee Joint; Osteoarthritis; Osteoarthritis, Hip; Osteoarthritis, Knee; Warfarin

The role of aspirin in the prevention of heterotopic ossification (HO) following total hip arthroplasty (THA) has been debated. This retrospective comparative study assesses the results of 167 total hip arthroplasties (THAs) performed between August 1998 and April 2005 on 150 consecutive patients (17 bilaterals) who were 70 years of age and under by a single orthopaedic surgeon. A comparison of the incidence and severity of HO between those patients who received aspirin (325 mg bid) with those who received Coumadin® (wafarin) for pharmacologic thromboprophylaxis. Surgery was performed through a posterolateral approach, with an enhanced soft tissue repair. There were 34 patients (35 hips) in the aspirin group and 68 patients (82 hips) in the Coumadin® group. All patients received prophylaxis for 6 weeks postoperatively. HO was classified according to Brooker and colleagues using anterior-posterior (AP) radiographs at last follow-up (range, 1 to 8 years). There were four hips (11.4%) with HO in the aspirin group and 28 (34.2%) in the Coumadin® group (p = 0.012). HO class III and IV was not detected in the aspirin group, but was in seven hips in the Coumadin® group (p = 0.13). Males had an incidence of HO of 40.4% (19 of 47 hips) and females had an incidence of 18.6% (13 of 70 hips) (p = 0.009). Males who received aspirin developed HO in 22.2% (4 of 18 hips), compared to 51.7% (15 of 29 hips) in the Coumadin® group (p = 0.045). No females (0 of 17 hips) who received aspirin developed HO, compared to 24.5% (13 of 53 hips) in females who received Coumadin® (p = 0.024). In this analysis, aspirin thromboprophylaxis decreased the prevalence of HO following elective THA in both females and males. This effect was not seen in patients who received Coumadin® after surgery.

Topics: Aged; Arthroplasty, Replacement, Hip; Aspirin; Chi-Square Distribution; Elective Surgical Procedures; Female; Fibrinolytic Agents; Humans; Incidence; Male; Middle Aged; Ossification, Heterotopic; Osteoarthritis, Hip; Radiography; Retrospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Thromboembolism; Time Factors; Treatment Outcome; Warfarin

Heterotopic ossification (HO) is a frequent complication after total hip arthroplasty (THA). We retrospectively evaluated the prevalence and severity of HO in patients with osteoarthrosis who underwent 1-stage bilateral THA (OSBTHA) and compared those who received aspirin with those who received Coumadin for postoperative chemothromboprophylaxis. The aspirin group consisted of 66 patients (132 hips), with a mean age of 64 years (SD, 8.5). The Coumadin group consisted of 67 patients (134 hips), with a mean age of 60 years (SD, 10.2). Overall, HO was detected in 124 hips (46.6%). There were 43 hips (32.5%) with HO in the aspirin group and 81 (60.4%) in the Coumadin group (P < .00005). Aspirin significantly decreases the prevalence and severity of HO in comparison to Coumadin after OSBTHA.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Anticoagulants; Arthroplasty, Replacement, Hip; Aspirin; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Male; Middle Aged; Ossification, Heterotopic; Osteoarthritis, Hip; Prevalence; Retrospective Studies; Severity of Illness Index; Thrombosis; Warfarin

Protein S is an antithrombotic plasma protein that serves as a cofactor for another plasma protein, activated protein C. Patients who express a deficiency of protein S have an increased propensity to experience thromboembolic events. These events are often precipitated by factors that may cause thrombosis in nondeficient individuals, particularly in cases of trauma, pregnancy, or surgery. Anticoagulation therapy was instituted in a 45-year-old woman with known protein S deficiency and bilateral total hip arthroplasties.

Topics: Female; Heparin; Hip Prosthesis; Humans; Middle Aged; Osteoarthritis, Hip; Plasma; Postoperative Complications; Protein S; Protein S Deficiency; Thromboembolism; Thrombosis; Warfarin

Topics: Aged; Female; Hip Prosthesis; Humans; Necrosis; Osteoarthritis, Hip; Postoperative Complications; Skin; Warfarin