Hip Function Was Not Associated with the Incidence of Preoperative Deep Vein Thrombosis in Patients Undergoing Primary Total Hip Arthroplasty

The prevalence of preoperative deep vein thrombosis (DVT) has been reported to be relatively high in patients undergoing total hip arthroplasty. We investigated the prevalence of DVT, the association between hip function and preoperative DVT, and the effect of a history of surgery in patients who underwent primary total hip arthroplasty. We retrospectively analyzed the cases of the patients who underwent primary total hip arthroplasty between April 2013 and February 2020 at our institution. We evaluated the prevalence of preoperative DVT based on the results of the patients’ ultrasound screening. We performed univariate and multivariate analyses to investigate the association between the incidence of DVT and patient factors including age, sex, hip function, medical histories, and American Society of Anesthesiologists Physical Status classification. We analyzed 451 patients (494 hips). The prevalence of DVT was 14.2% (64 patients). The multivariate analysis demonstrated that increased age was an independent significant risk factor for DVT. The prevalence of preoperative DVT was relatively high among patients who underwent primary total hip arthroplasty. Preoperative DVT tended to be more prevalent in older patients. Hip function was not associated with the incidence of DVT

Patient- and Surgery-Related Factors that Affect Patient-Reported Outcomes after Total Hip Arthroplasty

Patient-reported outcome measures (PROMs) are used to assess satisfaction after total hip arthroplasty (THA); however, the factors that determine these PROMs remain unclear. This study aimed to identify the patient- and surgery-related factors that affect patient satisfaction after THA as indicated by the Oxford Hip Score (OHS). One-hundred-and-twenty patients who underwent primary THA were included. Various patient-related factors, including clinical scores, and surgery-related factors were examined for potential correlations with the OHS at 3, 6, and 12 months post-THA. Univariate regression analysis showed that higher preoperative University of California Los Angeles (UCLA) activity score (p = 0.027) and better preoperative OHS (p = 0.0037) were correlated with better OHS at 3 months post-THA. At 6 months post-THA, the factors associated with better OHS were higher preoperative UCLA activity score (p = 0.039), better preoperative OHS (p = 0.0006), and use of a cemented stem (p = 0.0071). At 12 months post-THA, the factors associated with better OHS were higher preoperative UCLA activity score (p = 0.0075) and better preoperative OHS (p < 0.0001). Multivariate regression analysis showed that the factors significantly correlated with better OHS were female sex (p = 0.011 at 3 months post-THA), osteoarthritis (p = 0.043 at 6 months), higher preoperative OHS (p < 0.001 at 3 and 12 months, p = 0.018 at 6 months), higher preoperative Harris Hip Score (p = 0.001 at 3 months), higher preoperative UCLA activity score (p = 0.0075 at 3 months), and the use of a cemented femoral component (p = 0.012 at 6 months). Patient- and surgery-related factors affecting post-THA PROMs were identified, although the effect of these factors decreased over time

Well-differentiated Papillary Mesothelioma of the Pleura Diagnosed by Video-Assisted Thoracic Surgical Pleural Biopsy: A Case Report

Well-differentiated papillary mesothelioma of the pleura (WDPM-P) is an extremely rare type of mesothelial tumor that is thought to be of low malignant potential. Herein, we report on a case of WDPM-P. A 74-year-old woman was admitted for evaluation of shortness of breath. Pleural effusion was observed in the right thorax. Computed tomography after chest drainage did not reveal any lung or pleural tumors. Abnormally high levels of hyaluronic acid were detected in the pleural effusion. Cytological examination of the effusion revealed Class V findings; however, it was difficult to distinguish mesothelioma from adenocarcinoma. Because immunological evaluation may have provided more information, video-assisted thoracic surgical pleural biopsy (VATS-PB) was performed. Biopsied frozen specimens were revealed to be mesothelioma, and so localized pleurectomy and partial resection of the diaphragm were performed. Pathological examination established a diagnosis of WDPM-P. Six years postoperatively, the patient is doing well. As demonstrated in the present case, combined VATS-PB and pathological studies are useful for the diagnosis of and determination of surgical indications for pleural malignancies