title: Changes in blood coagulation-fibrinolysis markers by pneumatic tourniquet during total knee joint arthroplasty with venous thromboembolism.
abstract: This study investigated changes in blood coagulation-fibrinolysis markers during total knee arthroplasty (TKA). Preoperative 16-row multidetector row computed tomography (MDCT) revealed no asymptomatic venous thromboembolism (VTE) in the 42 patients recruited. Using MDCT postoperatively, patients were divided into thrombus (asymptomatic VTE, 19 patients) and no-thrombus (23 patients) groups. Blood taken at intervals before and after pneumatic tourniquet release revealed increased plasminogen activator inhibitor type-1 (PAI-1) at 30s for both groups and at 90s (both P=0.01) in the thrombus group. D-dimer levels were highest at 30 and 90s for both groups (P = 0.01). PAI-1 and D-dimer levels were strongly correlated at both time points in the thrombus group. Inactivating fibrinolysis due to PAI-1 may lead to asymptomatic VTE after TKA.
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kikkawa
authors.affiliation: Research Division of Cell and Molecular Medicine, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Madoiwa
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sekiya
authors.affiliation: Department of Health Science, Daito Bunka University, Higashimatsuyama, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Hayasaka
authors.affiliation: Research Division of Cell and Molecular Medicine, Center for Molecular Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sakata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee; D015415:Biomarkers / Q000097:blood; D001777:Blood Coagulation / Q000502:physiology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D014111:Tourniquets; D054556:Venous Thromboembolism / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D017395:Plasminogen Activator Inhibitor 1; C036309:fibrin fragment D
keywords: cross-linked fibrin degradation products by leukocyte elastase (e-XDP); d-dimer; plasminogen activator inhibitor type 1; soluble fibrin monomer complex; total knee arthroplasty; venous thromboembolism