• Deep vein thrombosis
• Osteoarthritis
• Total knee arthroplasty
• Ultrasonography

• Humans
• Arthroplasty, Replacement, Knee/adverse effects
• Male
• Retrospective Studies
• Female
• Risk Factors
• Venous Thrombosis/epidemiology
• Venous Thrombosis/etiology
• Venous Thrombosis/diagnostic imaging
• Aged
• Incidence
• Osteoarthritis, Knee/surgery
• Osteoarthritis, Knee/epidemiology
• Middle Aged
• Fibrin Fibrinogen Degradation Products/analysis
• Fibrin Fibrinogen Degradation Products/metabolism
• Aged, 80 and over
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Postoperative Complications/diagnosis
• Age Factors
• Preoperative Period

• No.72204268 National Natural Science Foundation of China
• No.3332022002 Fundamental Research Funds for the Central Universities

• Caprini risk assessment model
• Healthcare Cost and utilization project (HCUP)
• Total hip arthroplasty
• Total knee arthroplasty
• Venous thromboembolism

• 202201020481 Science and Technology Planning Project of Guangzhou City, China
• 202201020495 Science and Technology Planning Project of Guangzhou City, China
• 82372435 National Natural Science Foundation of China
• 82272443 National Natural Science Foundation of China
• 2019A1515011647 Guangdong Basic and Applied Basic Research Foundation
• 2023A1515010501 Guangdong Basic and Applied Basic Research Foundation

• COVID-19
• fibrin monomer complexes
• venous thromboembolism

• Humans
• COVID-19/complications
• Venous Thromboembolism/diagnosis
• Venous Thromboembolism/epidemiology
• Venous Thromboembolism/etiology
• Retrospective Studies
• Fibrin Fibrinogen Degradation Products/analysis
• Prognosis
• Thrombosis/complications
• Biomarkers

• Deep venous thrombosis (DVT)
• Nomogram
• Prognosis
• Thrombin antithrombin complex (TAT)
• Total hip and knee arthroplasty (THA/TKA)

• 2021YFA1102600 The National Key R&D Program of China
• 82002293 National Natural Science Foundation of China
• 82272443 National Natural Science Foundation of China
• 202201020481 Science and Technology Planning Project of Guangzhou City, China
• 202201020495 Science and Technology Planning Project of Guangzhou City, China
• 2019A1515011647 Guangdong Basic and Applied Basic Research Foundation
• 2021A1515010693 Guangdong Basic and Applied Basic Research Foundation
• The National Key R&D Program of China

As the number of patients receiving total joint replacements continues to rise, considerable attention has been directed towards the early detection and prevention of postoperative complications. While D-dimer has long been studied as a diagnostic tool in venous thromboembolism (VTE), this assay has recently received considerable attention in the diagnosis of periprosthetic joint infection (PJI). D-dimer values are substantially elevated in the acute postoperative period after total joint arthroplasty, with levels often exceeding the standard institutional cutoff for VTE (500 µg/L). The utility of D-dimer in detecting VTE after total joint replacement is currently limited, and more research to assess its value in the setting of contemporary prophylaxis protocols is warranted. Recent literature supports D-dimer as a good to excellent biomarker for the diagnosis of chronic PJI, especially when using serum sample technique. Providers should exercise caution when interpreting D-dimer levels in patients with inflammatory and hypercoagulability disorders, as the diagnostic value is decreased. The updated 2018 Musculoskeletal Infection Society criteria, which includes D-dimer levels > 860 µg/L as a minor criterion, may be the most accurate for diagnosing chronic PJI to date. Larger prospective trials with transparent lab testing protocols are needed to establish best assay practices and optimal cutoff values for D-dimer in the diagnosis of PJI. This review summarizes the most current literature on the value of D-dimer in total joint arthroplasty and elucidates areas for future progress.

• D-dimer
• Diagnosis
• Periprosthetic joint infection
• Venous thromboembolism
• Deep vein thrombosis
• Arthroplasty

• D-dimer
• direct oral anticoagulants
• gynecologic cancer
• risk factors
• venous thromboembolism

• JP21K09531, JP17K11265, JP21K09486, JP19H03795 JSPS KAKENHI
• 2020-J-3 National Cancer Center Research and Development Fund

• COVID-19
• D-dimer
• Fibrin monomers
• Intensive care unit
• Longitudinal
• Thrombosis

Early predictive markers of venous thromboembolism (VTE) after total hip arthroplasty (THA)/total knee arthroplasty (TKA) remain unclear. Our study identified early predictive markers for VTE after THA/TKA.

A single-institution retrospective review study was conducted between May 2020 and April 2022 (n = 256). All patients underwent Doppler ultrasounds exam in preoperation and seventh day after surgery. Deep vein thrombosis (DVT) was defined by Doppler ultrasound of the lower extremities, which revealed thrombosis. Thrombin-antithrombin complex (TAT), thrombomodulin (TM), and plasmin-antiplasmin complex (PIC) concentration were tested from each patient’s preoperative and postoperative days 1, 4, 7, 14. These values were then accessed via receiver operating characteristic (ROC) curve analysis and further quantified the level of this risk by concentration.

On postoperative day 1 (pod-1), all patients’ TAT and PIC concentrations were significantly higher than those preoperatively (p < 0.05). The levels of TAT and PIC in patients in the DVT group on pod-1 were significantly higher than those in the non-DVT group (p < 0.05). At pod-1, the TAT concentration for DVT patients was 49.47 ng/mL compared to 20.70 ng/mL for non-DVT patients, PIC was 3.72μg/mL compared to 1.65μg/mL. ROC curve analysis demonstrated that a TAT concentration of 24.3 ng/mL had a sensitivity of 87.9% and a specificity of 69.1%.

TAT levels on pod-1 may predict DVT early after THA/TKA, which makes it possible for early intervention to decrease the incidence of DVT.

• Deep vein thrombosis
• Total hip arthroplasty
• Total knee arthroplasty

• Deep venous thrombosis
• Etiology
• Prevention
• Pulmonary thromboembolism
• Treatment
• Venous thromboembolism
• Wounds and injuries

During the perioperative period, coagulofibrinolytic activation occurs, which occasionally results in thromboembolic complications. However, natural perioperative coagulofibrinolytic responses have not been well investigated. The present study examined perioperative coagulofibrinolytic changes and their association with the development of venous thromboembolism (VTE).

We retrospectively analyzed the changes in coagulofibrinolytic markers for 7 days in 70 patients undergoing elective colorectal surgery. To explore the natural coagulofibrinolytic response, we investigated patients not undergoing perioperative chemical thromboprophylaxis.

Coagulation activation occurred from just after surgery to postoperative day (POD) 1, followed by a gradual decrease, but persisted to even POD 7. Fibrinolytic activity showed a tri-phasic response: activation, shutdown and reactivation. Consequently, fibrin/fibrinogen degradation product (FDP) and D-dimer levels continued to increase until POD 7. The development of deep vein thrombosis (DVT) was observed in 11 patients (15.7%). Postoperative sustained hyper-coagulation [soluble fibrin (SF) or thrombin–antithrombin complex (TAT) values on POD 7 > their normal limits] was significantly associated with the development of DVT (SF, p < 0.001; TAT, p = 0.001).

We found initial coagulation activation and a tri-phasic response of fibrinolytic activity after colorectal surgery. Thus, physicians need to pay attention to these responses when attempting to prevent or treat VTE.

• Coagulofibrinolysis
• Colorectal surgery
• Venous thromboembolism

• C - reactive protein
• D-dimer
• erythrocyte sedimentation rate
• natural course
• total joint arthroplasty

• Coagulation-fibrinolytic changes
• Inflammatory response
• Nutritional loss
• Total hip arthroplasty (THA)
• Tranexamic acid (TXA)

• Antifibrinolytic Agents
• Arthroplasty, Replacement, Hip
• Blood Loss, Surgical
• Enhanced Recovery After Surgery
• Fibrinogen
• Humans
• Postoperative Complications/prevention & control
• Prospective Studies
• Systemic Inflammatory Response Syndrome/drug therapy
• Systemic Inflammatory Response Syndrome/etiology
• Tranexamic Acid

• Coagulation function index
• breast cancer
• deep venous thrombosis (DVT)
• fibrinolysis function index
• postoperative

• Acute stroke
• Deep vein thrombosis
• Soleal vein diameter
• Ultrasonography

This paper included a retrospective review of the effect of tranexamic acid (TXA) combined with pressure bandaging on hemostasis of patients who received a unilateral total knee arthroplasty (TKA) from 2017 to 2019.

A total of 197 patients undergoing TKA were chosen to be classified into 2 groups, the compression bandage control group and compression bandage combined with TXA observation group. The patients received blood routine examination when they were in the 1st, 3rd, and 6th days of before and postoperation. Some parameters, such as hemoglobin (Hb), C-reactive protein (CRP), D-dimer value, fibrinogen, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), international normalized ratio (INR), and erythrocyte sedimentation rate (ESR), were also investigated.

In our research, the mean age was 66.54 ± 7.95 years. No difference was found in patient sex (P = 0.876) and age (P = 0.749) between groups. No differences were found in the levels of Hb, fibrinogen, TT, and INR between the 2 groups at each period (P > 0.05). The difference of PT was significantly different on the 1st day (P = 0.011), 3rd day (P = 0.010), and 6th day (P = 0.004) after surgery. Besides, the changes in APTT in observation group were clearly higher compared with the control group on the 3rd day (P = 0.001) and 6th day (P = 0.001). On the 3rd and 6th days after operation, the CRP level of the two groups increased continuously, and the CRP level was significantly higher in the observation group in comparison with the control group (P = 0.008, P = 0.010). On 1st and 3rd days after surgery, compared to the control group, the D-dimer level of patients in the observation group was distinctly fewer (P = 0.001, P = 0.027).

TXA combined with compression bandage is a potential option for the reduction of bleeding after TKA.

Venous thrombosis is a common and potentially fatal disease, because of its high morbidity and mortality, especially in hospitalized patients. To establish the diagnosis of venous thrombosis, in the last years, a multi-modality approach that involves not only imaging modalities but also serology has been evolving. Multiple studies have demonstrated the use of some biomarkers, such as D-dimer, selectins, microparticles or inflammatory cytokines, for the diagnosis and treatment of venous thrombosis, but there is no single biomarker available to exclusively confirm the diagnosis of venous thrombosis. Considering the fact that there are some issues surrounding the management of patients with venous thrombosis and the duration of treatment, recent studies support the idea that these biomarkers may help guide the length of appropriate anticoagulation treatment, by identifying patients at high risk of recurrence. At the same time, biomarkers may help predict thrombus evolution, potentially identifying patients that would benefit from more aggressive therapies. This review focuses on classic and novel biomarkers currently under investigation, discussing their diagnostic performance and potential benefit in guiding the therapy for venous thrombosis.

• D-dimer
• E-selectin
• P-selectin
• biomarkers
• diagnosis
• microparticles
• venous thrombosis

• Anticoagulants/pharmacology
• Anticoagulants/therapeutic use
• Biomarkers/metabolism
• Cytokines/metabolism
• Early Diagnosis
• Fibrin Fibrinogen Degradation Products/metabolism
• Humans
• Recurrence
• Selectins/metabolism
• Venous Thrombosis/blood
• Venous Thrombosis/diagnosis
• Venous Thrombosis/drug therapy

• Coagulation testing
• D-dimer
• fibrin monomer
• pregnancy
• within-subject biological variation

• d-dimer
• joint arthroplasty
• plasmin-α2–antiplasmin complex
• soluble thrombomodulin
• thrombin–antithrombin
• tissue plasminogen activator inhibitor complex
• venous thromboembolism

• Adult
• Aged
• Aged, 80 and over
• Area Under Curve
• Arthroplasty/adverse effects
• Biomarkers/blood
• Blood Coagulation
• Female
• Fibrinolysis
• Humans
• Male
• Middle Aged
• Postoperative Period
• Prognosis
• Prospective Studies
• Sensitivity and Specificity
• Time Factors
• Ultrasonography, Doppler
• Venous Thromboembolism/diagnosis
• Venous Thromboembolism/etiology

Venous thromboembolism (VTE) is a serious complication following total joint replacement. The use of rivaroxaban, a highly selective and direct factor Xa inhibitor, has been used widely as a safe and efficacious way to prevent VTE after total joint replacements. However, little is known about the diagnostic efficacy of plasma D-dimer test on deep vein thrombosis (DVT) in patients using rivaroxaban for thromboprophylaxis. The study is aimed to investigate the trend and the diagnostic efficacy of D-dimer test on DVT in patients with primary total knee arthroplasty (TKA) using rivaroxaban for thromboprophylaxis.

Two hundred TKA patients using rivaroxaban postoperatively as chemical prophylaxis were reviewed. D-dimer levels were checked at 4 h after the surgery and on postoperative days 1 and 4. Venography was used to document the presence of DVT. The Mann-Whitney U test was used to detect the differences in the D-dimer levels at different time points in patients with and without DVT, followed by Bonferroni corrections for p values. Receiver operating characteristics (ROC) curves were constructed to determine the best cutoff values of the D-dimer test at each time point after the surgery.

Twenty-nine of the 200 patients were found to have deep vein thrombosis by venography, resulting in an incidence of 14.5%. All patients with DVTs occurred in the distal calf veins, and only one patient was symptomatic. We found significant differences in D-dimer concentration between patients with and without DVT at postoperative day 4. The best cutoff value determined by receiver operating characteristics analysis was 3.8 mg/L at postoperative day 4, with an AUC equal to 63.5%, and a sensitivity, specificity, PPV, and NPV of 58.6, 76, 29.3, and 91.5%, respectively.

Rivaroxaban was effective on reducing DVT in patients undergoing TKA. Because all the DVTs occurred in the leg veins, decreased thrombus volume and size might result in poor accuracy of plasma D-dimer test in prediction or diagnosis of postoperative DVT.

• D-dimer
• Deep vein thrombosis
• Rivaroxaban
• Thromboprophylaxis
• Total knee arthroplasty
• Venous thromboembolism

We conducted a meta-analysis from randomized controlled trials (RCTs) and non-RCTs to assess the efficacy of aminocaproic acid in cases of primary total hip arthroplasty (THA) or total knee arthroplasty (TKA).

Potentially relevant academic articles were identified from the Cochrane Library, MEDLINE (1966–2017 October 31), PubMed (1966–2017 October 31), EMBASE (1980–2017 October 31), and ScienceDirect (1985–2017 October 31). Secondary sources were identified from the references of the included literature. The pooled data were analyzed using RevMan 5.1.

Three RCTs and four non-RCTs met the inclusion criteria. There were significant differences in total blood loss (mean difference (MD) = − 495.80, 95% CI − 837.29 to − 154.32, P = 0.004), drainage volume (MD = − 249.43, 95% CI − 286.78 to − 212.08, P < 0.00001), postoperative hemoglobin level (MD = 0.90, 95% CI 0.78 to 1.02, P < 0.00001), hemoglobin reduction (MD = − 0.75, 95% CI − 0.93 to − 0.57, P < 0.00001), transfusion rates (risk difference (RD) = − 0.17, 95% CI − 0.25 to − 0.09, P < 0.0001), average transfusion units (MD = − 0.28, 95% CI − 0.48 to − 0.09, P = 0.004), and length of hospital stay (MD = − 0.33, 95% CI − 0.43 to − 0.24, P < 0.00001) between the two groups. No significant differences were found regarding deep vein thrombosis (DVT) (RD = − 0.00, 95% CI − 0.01 to 0.00, P = 0.36) between the two groups.

The present meta-analysis indicated that the application of aminocaproic acid in THA or TKA decreases the total blood loss, drainage volume, transfusion rate, transfusion units per patient, and length of hospital stay and does not increase the risk of DVT.

• Aminocaproic acid
• Arthroplasty
• Blood loss
• Meta-analysis
• Transfusion