ASA as DVT prophylaxis gaining in popularity?

Keeping the blood flowing is part of core medical knowledge – then why the controversy? The image is CC by Andi Campbell-Jones

In a recent post I noted that there was a dissonance between what I’ve been taught in school and what is actually the case regarding thrombosis prophylaxis after orthopaedic surgery. A new study by Parvizi et. al. looks into different dosages of ASA as a thromboprophylaxis after joint arthroplasties. Coming from a country that has fully embraced LMWH this feels alien… regardless, there seems to be increasing evidence that challenges my point of view. Continue reading

Age before beauty

Sticking to the old, proven concepts have often turned out to be a good strategy in orthopaedics. Switching hip implants can be both cumbersome and hazardous. The image is CC by Trey Ratcliff.

Sticking to the old, proven concepts have often turned out to be a good strategy in orthopaedics. Switching hip implants can be both cumbersome and hazardous. The image is CC by Trey Ratcliff.

In my research I focus on patient factors and their impact on re-operation rates after total hip arthroplasties. While they do matter, the implant itself seems to be even more important. One of the most successful implant in the Swedish Hip Arthroplasty Registry is the Link Lubinus SP II implant, while some may argue that it’s an awesome design, I would argue that the tools that it comes with are awesome, thus limiting surgeon’s mistakes. This importance of skill is nicely illustrated in Peltola et al’s recent study, where they found an increased risk for revision during the first 3 years when introducing new implants, hazard ratio was 1.3 (95% CI 1.1 to 1.5) for the first 15 arthroplasties. This increased risk early on is commonly referred to as the learning curve, and may vary between implants. Continue reading