Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Arthroplasty - Hip
Abstract number: 25935
THE EFFECT OF THE FEMORAL COMPONENT SHAPE TO COAGULATION
SYSTEM IN TOTAL HIP ARTHROPLASTY.
Daisuke KOGA 1 , Tetsuya JINNO 1 , Yuki YAMAUCH 1 , Sadao MORITA 2 , Atsushi
OKAWA 1 , Takeshi MUNETA 1 , Kenichi SHINOMIYA 1
1 Tokyo Medical and Dental univ., Orthopaedic surg., Tokyo (JAPAN), 2 Tokyo Medical
and Dental univ., Rehabilitation med., Tokyo (JAPAN)
Purpose: As a prevention of venous thromboembolism (VTE) in total hip arthroplasty
(THA), postoperative mechanical/pharmacological prophylaxis was employed.
However, it would be insufficient to prevent VTE which occurs intraoperatively or
immediately after the operation. We hypothesized that femoral component shape
affects incidence of VTE, and compared perioperative change of coagulation system
between different types of femoral components. Materials and methods: In 41 cases
undergoing primary unilateral THA without cement for osteoarthritis, bone-preserving
type stem (Accolade®; Stryker) was used in 22 cases (preserving group), and fit-andfill
type stem (VerSys®; Zimmer/S-ROM-A®; Depuy) was used in 19 cases. Markers
of coagulation system (PT-INR, Fbg, D-Dimer, FDP, TAT, PIC) were measured
preoperatively and immediately after operation. D-Dimer and FDP were measured
also on 7th postoperative day. These values were compared between 2 groups.
Result: Preoperatively, none of the markers was significantly different between 2
groups. Immediately after operation, D-Dimer, FDP, TAT were significantly lower in
preserving group, PIC was lower in preserving group and difference was marginally
significant, PT-INR and Fbg were not significantly different. D-Dimer and FDP on 7th
postoperative day were not significantly different.Discussion: It was reported that
intramedullary reaming and insertion of the femoral component stimulates
coagulating system. In use of bone-preserving type stem, intramedullary reaming is
less than fit-and-fill type stem, and cancellous bone remains around femoral
component during implantation. Although further studies especially on imaging
assessment such as ultrasonography are needed, these results suggested that the
shape of femoral component affects latent risk of perioperative VTE.
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