Monocyte procoagulant activity and membrane-associated D dimer after knee replacement surgery

Area of Science:

• Biomedical Science
• Hematology
• Immunology

Background:

• Monocytes express procoagulant activity (PCA) and D-dimer, markers of coagulation activation.
• Postoperative thrombosis is a significant risk following orthopedic surgery, such as total knee replacement.
• The role of monocyte PCA and D-dimer in postoperative deep vein thrombosis (DVT) requires further investigation.

Purpose of the Study:

• To investigate monocyte PCA and D-dimer levels ex vivo after total knee replacement.
• To determine the correlation between monocyte PCA, D-dimer-positive monocytes, and plasma D-dimer levels.
• To examine the relationship between these coagulation markers and the incidence of postoperative DVT.

Main Methods:

• Monocyte PCA, D-dimer-positive monocytes, and plasma D-dimer were measured pre- and post-operatively in 11 patients.
• Monocytes were assessed with and without suboptimal stimulation.
• Phlebography was used to diagnose DVT on postoperative day 10.

Main Results:

• A significant increase in stimulated monocyte PCA was observed on postoperative day 10.
• Both the number of D-dimer-positive monocytes and plasma D-dimer levels significantly increased post-operatively.
• The number of D-dimer-positive monocytes correlated with both monocyte PCA and plasma D-dimer levels.

Conclusions:

• Total knee replacement surgery leads to increased monocyte PCA and D-dimer expression.
• While monocyte PCA and D-dimer are elevated post-surgery, they do not appear to be reliable predictors of DVT development in this cohort.
• Further research is needed to identify accurate biomarkers for predicting postoperative DVT.