Markers of thrombin generation during resurfacing and noncemented total hip arthroplasty: a pilot study.

Overview

BACKGROUND: Hip resurfacing arthroplasty (HRA) could be associated with an increased risk of deep vein thrombosis (DVT) compared to traditional noncemented THA because it involves greater dissection, increased kinking and distortion of the femoral vessels, takes longer to perform, and involves insertion of some cement into the femur. QUESTIONS/PURPOSES: Does HRA lead to greater risk of thromboembolism compared with noncemented THA? METHODS: We prospectively studied 20 patients receiving HRA and 20 receiving THA. All patients were younger than 67 years old and were similar in height, weight, American Society of Anesthesiologists status, and gender mix. Patients undergoing HRA were younger (mean, 50 versus 59 years), their surgery was longer (mean, 87 versus 65 minutes), and they required more crystalloid during surgery (mean, 2160 versus 1662 mL). Radial artery blood samples were taken at six events during surgery and assayed for prothrombin fragment F1 + 2 and thrombin-antithrombin III complex (TAT) using enzyme-linked immunosorbent assays. RESULTS: We observed no differences in the intraoperative increases in F1 + 2 and TAT between the two groups and no differences in surgical events. CONCLUSION: Based on these data, HRA and THA should have similar risk of thromboembolism as THA based on the parameters we measured. LEVEL OF EVIDENCE: Level I, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.