Research ArticleArticle
Risk of Venous Thromboembolism after Total Knee Arthroplasty in Patients with Rheumatoid Arthritis
Masahiro Izumi, Kiyoshi Migita, Mashio Nakamura, Yuka Jiuchi, Tatsuya Sakai, Takayuki Yamaguchi, Tomihiko Asahara, Yuichiro Nishino, Seiji Bito, Shigeki Miyata, Kenji Kumagai, Makoto Osaki, Masaaki Mawatari and Satoru Motokawa
The Journal of Rheumatology April 2015, jrheum.140768; DOI: https://doi.org/10.3899/jrheum.140768
Masahiro Izumi
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Kiyoshi Migita
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Mashio Nakamura
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Yuka Jiuchi
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Tatsuya Sakai
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Takayuki Yamaguchi
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Tomihiko Asahara
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Yuichiro Nishino
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Seiji Bito
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Shigeki Miyata
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Kenji Kumagai
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Makoto Osaki
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Masaaki Mawatari
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
Satoru Motokawa
From the Japanese National Hospital Organization (NHO)–Evidence-based Medicine (EBM) study group, and the Japanese study Prevention and Actual situation of Venous Thromboembolism after Total Arthroplasty (J-PSVT), and the Division of Clinical Epidemiology, NHO Tokyo Medical Center, Tokyo; Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine, Tsu; Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center, Osaka; Department of Orthopedic Surgery, Nagasaki University Hospital, Nagasaki; Department of Orthopedic Surgery, Saga University Hospital, Saga, Japan. Supported by a grant from the NHO (multicenter clinical studies for evidenced-based medicine). M. Izumi, MD; K. Migita, MD, Japanese NHO-EBM study group and J-PSVT; M. Nakamura, MD, Department of Clinical Cardiovascular Research, Mie University Graduate School of Medicine; Y. Jiuchi, PhD; T. Sakai, MD; T. Yamaguchi, MD; T. Asahara, MD; Y. Nishino, MD, Japanese NHO-EBM study group and J-PSVT; S. Bito, MD, Division of Clinical Epidemiology, NHO Tokyo Medical Center; S. Miyata, MD, Division of Transfusion of Medicine, National Cerebral and Cardiovascular Center; K. Kumagai, MD, Japanese NHO-EBM study group and J-PSVT; M. Osaki, MD, Department of Orthopedic Surgery, Nagasaki University Hospital; M. Mawatari, MD, Department of Orthopedic Surgery, Saga University Hospital; S. Motokawa, MD, Japanese NHO-EBM study group and J-PSVT. Address correspondence to Dr. K. Migita, Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, Omura 856-8652, Japan. E-mail: migita@nagasaki-mc.com Accepted for publication February 25, 2015.
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Abstract
Objective To compare the incidence of venous thromboembolism (VTE) following total knee arthroplasty (TKA) between patients with rheumatoid arthritis (RA) and those with osteoarthritis (OA).
Methods The subjects were composed of 1084 Japanese patients with OA and 204 with RA. Primary effectiveness outcomes were any deep vein thrombosis (DVT) as detected by bilateral ultrasonography up to postoperative Day 10 (POD10) and pulmonary embolism (PE) up to POD28. The main safety outcomes were bleeding and death from any cause up to POD28. Plasma D-dimer levels were measured before and at POD10 after TKA.
Results The study cohort was composed of 1288 patients from 34 hospitals. There was no death up to POD28. PE occurred in 2 patients with OA and in no patients with RA. The incidence of primary effectiveness outcome was 24.3% and 24.0% in patients with OA and RA, respectively. The incidence of major bleeding up to POD28 was 1.3% and 0.5% in patients with OA and RA, respectively. No differences in the incidence of VTE (symptomatic/asymptomatic DVT plus PE) or bleeding were noted between patients with RA and OA. D-dimer levels on POD10 were significantly higher in patients with OA compared with those with RA. Also, D-dimer levels on POD10 were significantly lower in patients receiving fondaparinux than in patients without pharmacological prophylaxis.
Conclusion Despite some differences in demographic data, patients with RA and OA have equivalent risks of VTE and bleeding following TKA.
In this issue
The Journal of Rheumatology
Vol. 49, Issue 7
1 Jul 2022
Risk of Venous Thromboembolism after Total Knee Arthroplasty in Patients with Rheumatoid Arthritis
Masahiro Izumi, Kiyoshi Migita, Mashio Nakamura, Yuka Jiuchi, Tatsuya Sakai, Takayuki Yamaguchi, Tomihiko Asahara, Yuichiro Nishino, Seiji Bito, Shigeki Miyata, Kenji Kumagai, Makoto Osaki, Masaaki Mawatari, Satoru Motokawa
The Journal of Rheumatology Apr 2015, jrheum.140768; DOI: 10.3899/jrheum.140768
Risk of Venous Thromboembolism after Total Knee Arthroplasty in Patients with Rheumatoid Arthritis
Masahiro Izumi, Kiyoshi Migita, Mashio Nakamura, Yuka Jiuchi, Tatsuya Sakai, Takayuki Yamaguchi, Tomihiko Asahara, Yuichiro Nishino, Seiji Bito, Shigeki Miyata, Kenji Kumagai, Makoto Osaki, Masaaki Mawatari, Satoru Motokawa
The Journal of Rheumatology Apr 2015, jrheum.140768; DOI: 10.3899/jrheum.140768
