Abstract
EVALUATION ON THE CLINICAL STATUS OF PERI-OPERATIVE TOTAL KNEE REPLACEMENT (TKR) PATIENTS UNDER ANTIPLATELET THERAPY

Dr. S. Sathyamoorthi, Neenu Wilson, Neeya Johny*, Niranjana S., Nivashini T. and Pavithra S.

ABSTRACT

Aim: The aim of the study is to evaluate the clinical status of the peri-operative total knee replacement patients under antiplatelet therapy.

Objective: To compare the bleeding time, clotting time, drain collected from site of surgery, duration of hospital stay and suture removal in patients under antiplatelet treatment regimen with those not under an antiplatelet therapy.

Methodology: A Prospective Observational Study was conducted in the department of orthopaedics at Vivekanandha Medical Care Hospital,Tiruchengode-Namakkal for a period of 2 months from December 2020 to January 2021 to evaluate the clinical status of the peri-operative total knee replacement patients under antiplatelet therapy. All the anthropometric, clinical and laboratory data of the patients were collected and the statistical analysis was done.

Results: A total of 50 Osteoarthritis patients who required an immediate TKR was included in our study based on the inclusion and exclusion criteria. Among these 50 patients, 28 (56%) were females and 22 (44%) were males. The age group between 61-70 years had maximum number of patients. Average bleeding and clotting time was prolonged in those under an antiplatelet therapy. The average amount of drain collected after surgery in this group was also higher when compared to those not under an antiplatelet therapy. Days of hospital stay and suture removal was also prolonged in the antiplatelet group when compared to those not under an antiplatelet treatment regimen.

Conclusion: Antiplatelet treatment regimen are the first-line therapy in preventing cardiovascular thrombotic events and other cardiac complications.When patients on antiplatelet therapy have to undergo surgery , the perioperative team must design an optimal strategy to manage antiplatelet medicines. Each patient must be classified according to risk of developing a cardiovascular thrombotic event and risk of surgical bleeding. Later various therapeutic strategies including continuing or discontinuing all or maintaining any one antiplatelet agent should be made. Proper management of antiplatelets as recommended in a perioperative setting would be necessary for better patient health outcomes. 

Keywords: Antiplatelet therapy, Total Knee Replacement, Clotting time, Bleeding time, Suture removal.


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