caa a22 4500 605460752 CHVBK 20210128100240.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s00167-014-3141-z doi (NATIONALLICENCE)springer-10.1007/s00167-014-3141-z Less deep vein thrombosis due to transcutaneous fibular nerve stimulation in total knee arthroplasty: a randomized controlled trial [Elektronische Daten] [Masashi Izumi, Masahiko Ikeuchi, Koji Aso, Natsuki Sugimura, Yuko Kamimoto, Tetsuya Mitani, Tadashi Ueta, Takayuki Sato, Masataka Yokoyama, Tetsuro Sugiura, Toshikazu Tani] Purpose: It has been known for years that deep vein thrombi (DVT) start to develop during total joint arthroplasty. Previously, we reported effective prevention of venous stasis by transcutaneous electrical nerve stimulation (TENS). It is hypothesized that TENS might be a thromboprophylactic tool for the limb undergoing surgery. The purpose of this study is to clarify the clinical efficacy and safety of TENS in patients during total knee arthroplasty (TKA). Methods: Ninety patients undergoing primary TKA were involved and randomly allocated to the TENS or control group. In the TENS group, electrical stimulation of the common fibular nerve, which produced a brisk dorsiflexion of the ankle, was performed for the operated leg during surgery. In the control group, no electrical stimulation was applied. Serum D-dimer and soluble fibrin monomer complex (SFMC) levels were measured before surgery, immediately after surgery, and post-operative day (POD) 1. Ultrasonography was performed on POD 1. Results: Immediately after surgery, D-dimer and SFMC levels of each group were significantly lower in the TENS group compared with control (p<0.05). The incidence of DVT was 11% (five cases) in the TENS group while 31% (14 cases) in control (p=0.02). There were no adverse effects related to TENS. Conclusions: TENS during TKA showed significant effects on preventing DVT. Sustaining muscle pump activation during surgery prevented not only venous stasis, but also hypercoagulability of blood. Intraoperative TENS is a safe and novel strategy against early post-operative thromboembolism, which is difficult to be completed through existing prophylaxis after total joint arthroplasty. Level of evidence: Randomized controlled trial, Level I. Springer-Verlag Berlin Heidelberg, 2014 Venous thromboembolism (VTE) nationallicence Deep vein thrombosis (DVT) nationallicence Pulmonary thromboembolism (PTE) nationallicence Transcutaneous electrical nerve stimulation (TENS) nationallicence Total knee arthroplasty (TKA) nationallicence Prevention nationallicence Izumi Masashi Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut Ikeuchi Masahiko Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut Aso Koji Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut Sugimura Natsuki Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut Kamimoto Yuko Department of Anesthesiology, Kochi University, Nankoku, Japan aut Mitani Tetsuya Department of Clinical Laboratory, Kochi University, Nankoku, Japan aut Ueta Tadashi Department of Clinical Laboratory, Kochi University, Nankoku, Japan aut Sato Takayuki Department of Cardiovascular Control, Kochi University, Nankoku, Japan aut Yokoyama Masataka Department of Anesthesiology, Kochi University, Nankoku, Japan aut Sugiura Tetsuro Department of Clinical Laboratory, Kochi University, Nankoku, Japan aut Tani Toshikazu Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3317-3323 0942-2056 23:11<3317 2015 23 167 https://doi.org/10.1007/s00167-014-3141-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3141-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Izumi Masashi Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut NATIONALLICENCE 700 1- Ikeuchi Masahiko Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut NATIONALLICENCE 700 1- Aso Koji Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut NATIONALLICENCE 700 1- Sugimura Natsuki Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut NATIONALLICENCE 700 1- Kamimoto Yuko Department of Anesthesiology, Kochi University, Nankoku, Japan aut NATIONALLICENCE 700 1- Mitani Tetsuya Department of Clinical Laboratory, Kochi University, Nankoku, Japan aut NATIONALLICENCE 700 1- Ueta Tadashi Department of Clinical Laboratory, Kochi University, Nankoku, Japan aut NATIONALLICENCE 700 1- Sato Takayuki Department of Cardiovascular Control, Kochi University, Nankoku, Japan aut NATIONALLICENCE 700 1- Yokoyama Masataka Department of Anesthesiology, Kochi University, Nankoku, Japan aut NATIONALLICENCE 700 1- Sugiura Tetsuro Department of Clinical Laboratory, Kochi University, Nankoku, Japan aut NATIONALLICENCE 700 1- Tani Toshikazu Department of Orthopaedic Surgery, Kochi University, Oko-cho Kohasu, 783-8505, Nankoku, Japan aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/11(2015-11-01), 3317-3323 0942-2056 23:11<3317 2015 23 167