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Heparin versus enoxaparine for prevention of asymptomatic deep venous thrombosis after total knee arthroplasty

Background: Venous thromboembolic disease (VTED) is a well known complication that occur following total knee arthroplasty (T.K.A). One of the (VTED) forms is asymptomatic deep venous thrombosis with an incidence has been estimated to be up to ³ 20% in patients undergone primary T.K.A , despite routine treatment with heparin postoperatively.

Objectives : is to assess the prevalence of post-operative asymptomatic D.V.T among patients receiving two different thromboprophylactic drugs after T.K.A.

Patients and methods: 68 patients who had T.K.A were randomly divided for the purpose of post-operative thromboprophylaxis into two groups , group [ A ] (control group) consisted of 35 patients received heparin, and group [B] of 33 patients received low molecular weight heparin (L.M.W.H) (enoxaparin) subcutaneously. Both groups were given the drug for two weeks post-operatively, then aspirin untill the 6th week after surgery. Bilateral Duplex U/S performed preoperatively and postoperatively at 5-7 days. The third ultrasonography was performed on the third week after surgery on all patients. the evaluation of the result expressed as primary efficacy outcome which was the composite of D.V.T (either symptomatic or detected by Ultrasonography  if the patient was asymptomatic). Non-fatal pulmonary embolism or death from any cause at 42 days after surgery, were also evaluated with a confidence interval (C.I.)

Results: The overall incidence of asymptomatic D.V.T was 2.94% (2 in 68 patients). Those two patient were in heparin group; (group [A]) which represent 11.4% that is highly significant, while no cases (0%) reported among enoxaparin group; Group [B].

Conclusion: Enoxaparin significantly lowered the prevalence of deep vein thrombosis (D.V.T.) after T.K.A.

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Publication Date
Sun Apr 24 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Duplex ultrasound surveillance for asymptomatic deep venous thrombosis after total knee joint replacement

Background: The prevalence of deep veins thrombosis, complicating total knee replacement in Asian countries, has not been fully appreciated in comparison to western countries as there are few studies on that. There is an important correlation between the evidence of deep veins thrombosis in the lower extremity and likelihood of   pulmonary embolism later one . Because of its noninvasive nature, duplex ultrasound has become one of the initial dependable modality for the cheek out of deep veins thrombosis after total knee replacement  . Therefore, this study was designed to evaluate the outcome of asymptomatic after total knee replacement by duplex ultrasound among Iraqi patients.

Methods: This

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Publication Date
Fri Dec 30 2011
Journal Name
Al-kindy College Medical Journal
The Role of the Use of Low Molecular Weight Heparin in the Prevention of Deep Venous Thrombosis after Total Knee Arthroplasty

Background A prospective clinical study was
performed to compare the efficacy of the use of lowmolecular-
weight heparin group (enoxparin group)
with control group in the prevention of deep-vein
thrombosis after total knee arthroplasty.
Aim of the study: to assess the prevalence of DVT
after total knee arthroplasty and evaluate the
importance of the use of low molecular weight
heparin in the prevention of this DVT.
Methods Thirty-three patients undergoing total
knee arthroplasty were randomly divided into two
groups. One group consisted of 12 patients who
received no prophylaxis with an anticoagulant (the
control group), other group consisted of 21 patients
who received the low-molecular-weight h

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Publication Date
Mon Jul 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Intramedullary Versus Extramedullary Alignment Guide for the Accurate Sagital Tibial Prosthesis Alignment in Total Knee Replacement Arthroplasty

Background: long term survivorship in total knee arthroplasty is significantly dependant on prosthesis alignment, several studies have correlated poor outcome with malalignment of the components. The debate on the optimal system for femoral alignment is now largely resolved, but there is still controversy about whether intramedullary or extramedullary systems are better for the tibial side.

Objecives :  is to determine whether intramedullary or extramedullary tibial alignment guide is better for accurate sagital tibial prosthesis alignment in total knee replacement arthroplasty.

Patients and methods: Of 65 patients recruited, only 48 patients (55 knees) were met the

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Publication Date
Wed Jul 01 2015
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Do low back pain changes correlate with sagittal lumbar alignment changes after total hip replacement arthroplasty?

Background: The hip joint and lumbar spine are both anatomically and functionally closely related as had shown by many authors. So the abnormality in one area can affect the other e.g. hip joint osteoarthritis can cause lumbar sagittal malalignment and backache.
Objectives: is to see if there is significant improvement in backache after total hip replacement? And which degree of backache improvement is associated with significant changes in lumbar lordosis?
Methods and patients: a prospective open trial study was performed on 30 patients who had severe hip osteoarthritis and chronic low back pain. Total hip replacement was performed to all patients. Backache and lumbar lordosis were measured by visual analogue scale and Cobb’s an

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Publication Date
Sun Oct 02 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Factor V Leiden Mutation in Iraqi Patients with Deep Venous Thrombosis.

Background: Factor V Leiden is considered the most common inherited risk factor for venous thrombosis in Caucasian populations, including those in the Eastern Mediterranean region. While several studies have addressed Factor V Leiden prevalence in patients with venous thrombosis in the Eastern Mediterranean countries, none have been reported from Iraq.
Objective: To study the prevalence of Factor V Leiden in an unselected group of Iraqi patients with Deep Venous thrombosis.
Materials and Methods: A total of 50 unselected patients with deep venous thrombosis referred to the Medical City Teaching Hospital in Baghdad, Iraq, as well as 40 age and sex matched controls, were enrolled. The evaluation included in addition to detailed histo

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Publication Date
Tue Jul 13 2021
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Catheter directed thrombolysis for acute deep vein and arterial thrombosis in COVID-19: report of two cases from Sulaymaniyah, Kurdistan-Iraq: Catheter directed thrombolysis for COVID-19 thrombosis

Abstract

As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onse

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Arthroscopic micro fracture and intra articular whole bone marrow injection for the treatment of articular cartilage lesions in the knee joint.

Background: Articular cartilage lesions in the knee joint are frequently seen,its treatment represents a challenge for orthopedic surgeons especially in young age patients and if left untreated,then they can progress to advanced osteoarthritis that may affect the functional status of the patients.Many treatment modalities had developed for these lesions, in the current study arthroscopic micro fracture plus intra articular whole bone marrow(WBM) injection was used as modality of treating these lesions.
Objectives: to assess the effectiveness of arthroscopic micro fracture plus WBM intra articular injection as a treatment modality for knee articular cartilage lesions.
Patients and Methods : a prospective experimental study was perfo

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Publication Date
Wed Jan 05 2022
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Risk Factors of Knee Osteoarthritis in Patients attending Rheumatology Clinic in Mosul

Background: Osteoarthritis can be described as the last common pathway of processes that leads to joint failure. This illness also has a significant social and economic impact on all civilizations, and has become a growing burden on health-care systems in usually healthy economies with an aging population.

Methods: A case-control study design conducted from the 1st, November 2020 to the 31st, May 2021 in Ibn-Sena and Al-Salam Teaching Hospitals in Mosul, Iraq. A total of 100 individuals diagnosed with knee Osteoarthritis represent

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Comparative study of anterior knee pain after patelloplasty with and without circumferential denervation in a total knee arthroplasty

Background: The anterior knee pain is an important chief complaint of the patients with knee osteoarthritis due to patellofemoral pathology. The pain receptors denervation can be achieved by circumferential denervation of the patellar area by a process of electrocautery.

Objectives: The aim of current study is to assess the pain after total knee arthroplasty (TKA) by patelloplastywith and without circumferential denervation via electrocautery at a minimum follow up with 1 year separately for each patient.

Type of the study:Cross- sectional study.

Methods: Thirty five patients,with mean age of about (62.8) years, were enrolled in this pros

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Comparative study between Harmonic FOCUSTM to clamp and tie technique for total thyroidectomy

Background: Thyroid surgery has undergone many changes during the past 2 decades, including the introduction of new surgical techniques such as endoscopic or video-assisted approaches, anesthesia care, intraoperative nerve monitoring and new hemostatic tools
Objectives: to assess the efficacy and safety of Harmonic Focus shears in total thyroidectomy compared with conventional surgical technique.
Patients and methods: prospective study conducted from October 2011 till January 2016, two handers and nine patients with benign and malignant thyroid diseases, scheduled for total thyroidectomy in a governor and private hospitals were enrolled randomly into 2 groups, group A consists of 105 patient who undergone a total thyroidectomy usin

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