Blood coagulation and fibrinolytic activity during femoral neck prosthetic replacement using bone cement.
To assess the blood coagulative and fibrinolytic responses during cemented femoral neck replacement, we measured these parameters in 9 patients, including anti-thrombin III (AT-III), prothrombin time (PT) and activated partial thromboplastin time (APTT) before surgery, just before packing bone cement and after the insertion of the prosthesis. We also measured thrombin-anti-thrombin III complex (TAT), plasmin-alpha 2-plasmin inhibitor complex (PIC), and D-dimer. A significant increase in APTT, and decrease in AT-III and PT were observed before the insertion of bone cement and prosthesis. The value of TAT and D-dimer increased significantly after the insertion of the prosthesis, but there were no significant changes in PIC. The data suggest that blood coagulation is activated after the insertion of bone cement and prosthesis into the femoral shaft, and in addition, the fibrinolysis is also accelerated secondary to the activation of the coagulation. Further investigations are needed to establish whether the activation of the coagulation induced by the cemented replacement exerts a great influence on the appearance of pulmonary thrombosis or circulatory depression.
Fujimura
N
N
Department of Anesthesiology, Sapporo Medical University School of Medicine.
Kawamata
M
M
Yamaya
K
K
Nakae
Y
Y
Tsukamoto
T
T
Miyabe
M
M
Namiki
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D001843:Bone Cements / Q000009:adverse effects*; D005260:Female; D005272:Femur Neck / Q000601:surgery*; D005342:Fibrinolysis; D006622:Hip Prosthesis / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged
D001843:Bone Cements