Microcirculatory and Hemostatic Changes in Patients after Endoprosthetic Hip Joint Replacement

Microcirculatory and Hemostatic Changes in Patients after Endoprosthetic Hip Joint Replacement

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Objective: to estimate the values of microcirculation, hemostasis, and fibrinolysis in patients after hip joint replacement.Subjects and methods.Thirty-two patients were examined after total endoprosthetic hip joint replacement (TEHJR).Microcirculation was explored by laser Doppler flowmetry (LDF).The level of ADAMTS-13 and its inhibitor and the concentrations of tissue factor pathway inhibitor (TFPI), tissue plasminogen baby toys activator (t-PA), and tissue plasminogen activator inhibitor-1 (PAI-1) were measured in the patients’ plasma by enzyme immunoassay.

Results.Analysis of LDF measurements of the operated limb showed a 1.3-fold reduction in the value of microcirculation as compared with the intact limb in the patients in the early postoperative period after TEHJR.There were 1.3- and 1.

4-fold increases in neurogenic and myogenic tones, respectively.The shunting ratio was 15% higher in the operated versus intact limb.The content of ADAMTS-13 was increased by 1.4-fold in the blood of the operated limp.As compared with the control group, the blood level of TFPI in the operated and intact limbs was elevated by 1.

8 and 1.6 times, respectively.As compared with the controls, the patients after hip joint replacement displayed 1.9- and 1.6-fold decreases in the blood concentration of t-PA and PAI-1, respectively.

Conclusion.In the patients after hip joint replacement, the value of microcirculation was lower, neurogenic and myogenic tones were higher, as well as there were increases in the levels of ADAMTS-13 and TFPI in the blood flowing from the operated limb as compared with the intact one.The plasma content of t-PA and PAI-1 became lower in the post-TEHJR patients than that in the control group.Key Airliner words: endoprosthetic hip joint replacement, microcirculation, hemostasis.