Pharmacologic Prophylaxis and Treatment of Venous Thromboembolism after Knee Arthroplasty

The objective of this study was to evaluate the efficacy of unfractionated heparin, warfarin and low molecular weight heparins (LMWH) used for the prevention of venous thromboembolism in arthroplastic surgery of the knee joint. Methods: In this prospective study from August 2002 to November 2004, 60 patients were included and divided into three groups with equal numbers, with each group receiving different treatment protocol. Postoperatively, the occurrence of symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) was recorded during the first 30 days after surgery and at a routine follow-up visit. Results: A significantly lower prevalence of DVT and PE was found in patients using warfarin and LMWH as prophylaxis in comparison with patients using unfractionated heparin. Conclusion: Warfarin and low molecular weight heparins are more beneficial and effective than unfractionated heparin for DVT and PE prophylaxis in arthroplastic knee surgeries.

Medial Patellofemoral Ligament Reconstruction

Recurrent patellofemoral instability is a common disabling condition especially in young individuals. MPFL is the main stabilizer to lateral patellar displacement and its reconstruction will restore patellofemoral stability. Many techniques had been described to reconstruct MPFL with good results and few complications taking in consideration meticulous surgical technique and careful patient selection. We used hamstring autograft in a double bundle anatomic MPFL reconstruction technique with both ends of the graft fixed to patella through two blind tunnels by anchor and bioabsorbable interference screw fixing the graft through a blind tunnel in the femur at 30 degree flexion

Pharmacologic Prophylaxis and Treatment of Venous Thromboembolism after Knee Arthroplasty

The objective of this study was to evaluate the efficacy of unfractionated heparin, warfarin and low molecular weight heparins (LMWH) used for the prevention of venous thromboembolism in arthroplastic surgery of the knee joint. Methods: In this prospective study from August 2002 to November 2004, 60 patients were included and divided into three groups with equal numbers, with each group receiving different treatment protocol. Postoperatively, the occurrence of symptomatic deep vein thrombosis (DVT) or pulmonary embolism (PE) was recorded during the first 30 days after surgery and at a routine follow-up visit. Results: A significantly lower prevalence of DVT and PE was found in patients using warfarin and LMWH as prophylaxis in comparison with patients using unfractionated heparin. Conclusion: Warfarin and low molecular weight heparins are more beneficial and effective than unfractionated heparin for DVT and PE prophylaxis in arthroplastic knee surgeries.

Giant Cell Tumor of Tendon Sheath in the Knee

The giant cell tumor of the tendon sheath (GCTTS) is a benign lesion which arises from the synovium of a joint, bursa or tendon sheath, with 85% of the tumors occurring in the fingers and 12% of the tumors located in large joints such as the knee and ankle. The GCTTS is usually monoarticular, slowly proliferative and rarely locally aggressive. This paper reports three cases of this rare lesion in the knee. Patients presented with painful swelling in the anterior knee, MRI showed localized soft tissue masses which were able to be excised. A follow up of the cases showed no recurrences. This case report emphasizes the importance of considering GCTTS in the differential diagnosis of soft tissue swelling and pain in large joints