title: The use of factor Xa inhibitors following opening-wedge high tibial osteotomy for venous thromboembolism prophylaxis.
abstract: OBJECTIVE
  This study aimed to investigate the incidence of venous thromboembolism (VTE) after medial opening-wedge high tibial osteotomy (OWHTO) and evaluate the efficacy and safety of edoxaban for the prevention of VTE in patients undergoing OWHTO.
  
  
  METHODS
  A total of 139 patients with osteoarthritis or osteonecrosis undergoing OWHTO were enrolled in this prospective, randomized study. Four patients were excluded because of preoperatively diagnosed VTE, and 135 patients were divided into two groups-an edoxaban group and a non-edoxaban group-and underwent computed tomography venography on day 7 to check for postoperative VTE. Blood samples were taken on the day before OWHTO and on postoperative days 1, 3, 7, and 14.
  
  
  RESULTS
  Treatment with edoxaban reduced the incidence of VTE after OWHTO; however, there was no statistically significant difference between the two groups. No major bleeding was noted in the edoxaban group. There were significant differences in the D-dimer level, prothrombin time, fibrinogen level, and thrombin antithrombin complex levels between the groups.
  
  
  CONCLUSIONS
  Edoxaban is an oral, once-daily, selective, direct factor Xa inhibitor that is safe and easy to handle. It may offer a new option for preventing VTE after OWHTO.
  
  
  METHODS
  I.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan. hi-deo@live.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Akamatsu
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kumagai
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kusayama
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Ishigatsubo
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Shota
authors.initials: S
authors.lastname: Mitsuhashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Aratake
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama, Kanagawa, 236-0004, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Saito
mesh_terms: D000368:Aged; D000990:Antithrombin III; D065427:Factor Xa Inhibitors / Q000627:therapeutic use*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D010027:Osteotomy; D010447:Peptide Hydrolases / Q000097:blood; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D011517:Prothrombin Time; D011725:Pyridines / Q000627:therapeutic use*; D013844:Thiazoles / Q000627:therapeutic use*; D013977:Tibia / Q000601:surgery*; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D065427:Factor Xa Inhibitors; D005338:Fibrin Fibrinogen Degradation Products; D011725:Pyridines; D013844:Thiazoles; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; D000990:Antithrombin III; D005340:Fibrinogen; D010447:Peptide Hydrolases; C552171:edoxaban
keywords: Deep vein thrombosis (DVT); Edoxaban; Opening-wedge high tibial osteotomy (OWHTO); Pulmonary embolism (PE); Venous thromboembolism (VTE)