Markers of thrombin generation during resurfacing and noncemented total hip arthroplasty: a pilot study.
BACKGROUND
Hip resurfacing arthroplasty (HRA) could be associated with an increased risk of deep vein thrombosis (DVT) compared to traditional noncemented THA because it involves greater dissection, increased kinking and distortion of the femoral vessels, takes longer to perform, and involves insertion of some cement into the femur.


OBJECTIVE
Does HRA lead to greater risk of thromboembolism compared with noncemented THA?


METHODS
We prospectively studied 20 patients receiving HRA and 20 receiving THA. All patients were younger than 67 years old and were similar in height, weight, American Society of Anesthesiologists status, and gender mix. Patients undergoing HRA were younger (mean, 50 versus 59 years), their surgery was longer (mean, 87 versus 65 minutes), and they required more crystalloid during surgery (mean, 2160 versus 1662 mL). Radial artery blood samples were taken at six events during surgery and assayed for prothrombin fragment F1 + 2 and thrombin-antithrombin III complex (TAT) using enzyme-linked immunosorbent assays.


RESULTS
We observed no differences in the intraoperative increases in F1 + 2 and TAT between the two groups and no differences in surgical events.


CONCLUSIONS
Based on these data, HRA and THA should have similar risk of thromboembolism as THA based on the parameters we measured.


METHODS
Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY 10021, USA.
Edwin P
EP
Su
Nikos
N
Chatzoudis
Vasileios
V
Sioros
George
G
Go
Nigel E
NE
Sharrock
D000328:Adult; D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D015415:Biomarkers / Q000378:metabolism; D001777:Blood Coagulation / Q000502:physiology; D005260:Female; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology*; D011446:Prospective Studies; D011475:Prosthesis Failure; D012086:Reoperation; D013917:Thrombin / Q000096:biosynthesis*; D013923:Thromboembolism / Q000097:blood / Q000209:etiology*
D015415:Biomarkers; D013917:Thrombin