Thromboelastography for the Orthopaedic Surgeon

John Hagedorn, James M. Bardes, Creed L. Paris, Ronald Lindsey

Research output: Contribution to journalArticle

Abstract

Evaluation of coagulation is vital in the care of the orthopaedic patients, particularly in the subspecialties of trauma, spine, arthroplasty, and revision surgery resulting from blood loss and coagulopathies. Although conventional tests (prothrombin time/international normalized ratio, activated partial thromboplastin time, platelet count, and fibrinogen) are most commonly used, others like thromboelastography (TEG) are also available to the orthopaedic surgeons. TEG is a blood test developed in the 1950s, which provides a snapshot of a patient's coagulation profile by evaluating clot formation and lysis. Recently, TEG has been used to assess traumatic coagulopathy. The coagulation parameters measured by the TEG are reaction time (R-time), time to reach a certain clot strength (K-value), speed of fibrin build up (α-angle), maximum clot amplitude, and percentage decrease of clot in 30 minutes (LY30). Using these values, traumatologists have developed a better, faster, and more accurate overview of a patient's resuscitation and more successfully direct blood product use. However, many orthopaedic surgeons-despite performing surgical procedures that risk notable blood loss and postoperative clotting complications-are unaware of the existence of the TEG blood test and the critical information it provides. Increasing awareness of the TEG among orthopaedic surgeons could have a notable effect on numerous aspects of musculoskeletal care.

Original languageEnglish (US)
Pages (from-to)503-508
Number of pages6
JournalThe Journal of the American Academy of Orthopaedic Surgeons
Volume27
Issue number14
DOIs
StatePublished - Jul 15 2019

Fingerprint

Thrombelastography
Hematologic Tests
International Normalized Ratio
Partial Thromboplastin Time
Prothrombin Time
Fibrin
Platelet Count
Reoperation
Resuscitation
Arthroplasty
Fibrinogen
Orthopedics
Orthopedic Surgeons
Patient Care
Spine
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Thromboelastography for the Orthopaedic Surgeon. / Hagedorn, John; Bardes, James M.; Paris, Creed L.; Lindsey, Ronald.

In: The Journal of the American Academy of Orthopaedic Surgeons, Vol. 27, No. 14, 15.07.2019, p. 503-508.

Research output: Contribution to journalArticle

@article{338bb1ce50a3405ea5da844102185628,
title = "Thromboelastography for the Orthopaedic Surgeon",
abstract = "Evaluation of coagulation is vital in the care of the orthopaedic patients, particularly in the subspecialties of trauma, spine, arthroplasty, and revision surgery resulting from blood loss and coagulopathies. Although conventional tests (prothrombin time/international normalized ratio, activated partial thromboplastin time, platelet count, and fibrinogen) are most commonly used, others like thromboelastography (TEG) are also available to the orthopaedic surgeons. TEG is a blood test developed in the 1950s, which provides a snapshot of a patient's coagulation profile by evaluating clot formation and lysis. Recently, TEG has been used to assess traumatic coagulopathy. The coagulation parameters measured by the TEG are reaction time (R-time), time to reach a certain clot strength (K-value), speed of fibrin build up (α-angle), maximum clot amplitude, and percentage decrease of clot in 30 minutes (LY30). Using these values, traumatologists have developed a better, faster, and more accurate overview of a patient's resuscitation and more successfully direct blood product use. However, many orthopaedic surgeons-despite performing surgical procedures that risk notable blood loss and postoperative clotting complications-are unaware of the existence of the TEG blood test and the critical information it provides. Increasing awareness of the TEG among orthopaedic surgeons could have a notable effect on numerous aspects of musculoskeletal care.",
author = "John Hagedorn and Bardes, {James M.} and Paris, {Creed L.} and Ronald Lindsey",
year = "2019",
month = "7",
day = "15",
doi = "10.5435/JAAOS-D-17-00603",
language = "English (US)",
volume = "27",
pages = "503--508",
journal = "The Journal of the American Academy of Orthopaedic Surgeons",
issn = "1067-151X",
publisher = "American Association of Orthopaedic Surgeons",
number = "14",

}

TY - JOUR

T1 - Thromboelastography for the Orthopaedic Surgeon

AU - Hagedorn, John

AU - Bardes, James M.

AU - Paris, Creed L.

AU - Lindsey, Ronald

PY - 2019/7/15

Y1 - 2019/7/15

N2 - Evaluation of coagulation is vital in the care of the orthopaedic patients, particularly in the subspecialties of trauma, spine, arthroplasty, and revision surgery resulting from blood loss and coagulopathies. Although conventional tests (prothrombin time/international normalized ratio, activated partial thromboplastin time, platelet count, and fibrinogen) are most commonly used, others like thromboelastography (TEG) are also available to the orthopaedic surgeons. TEG is a blood test developed in the 1950s, which provides a snapshot of a patient's coagulation profile by evaluating clot formation and lysis. Recently, TEG has been used to assess traumatic coagulopathy. The coagulation parameters measured by the TEG are reaction time (R-time), time to reach a certain clot strength (K-value), speed of fibrin build up (α-angle), maximum clot amplitude, and percentage decrease of clot in 30 minutes (LY30). Using these values, traumatologists have developed a better, faster, and more accurate overview of a patient's resuscitation and more successfully direct blood product use. However, many orthopaedic surgeons-despite performing surgical procedures that risk notable blood loss and postoperative clotting complications-are unaware of the existence of the TEG blood test and the critical information it provides. Increasing awareness of the TEG among orthopaedic surgeons could have a notable effect on numerous aspects of musculoskeletal care.

AB - Evaluation of coagulation is vital in the care of the orthopaedic patients, particularly in the subspecialties of trauma, spine, arthroplasty, and revision surgery resulting from blood loss and coagulopathies. Although conventional tests (prothrombin time/international normalized ratio, activated partial thromboplastin time, platelet count, and fibrinogen) are most commonly used, others like thromboelastography (TEG) are also available to the orthopaedic surgeons. TEG is a blood test developed in the 1950s, which provides a snapshot of a patient's coagulation profile by evaluating clot formation and lysis. Recently, TEG has been used to assess traumatic coagulopathy. The coagulation parameters measured by the TEG are reaction time (R-time), time to reach a certain clot strength (K-value), speed of fibrin build up (α-angle), maximum clot amplitude, and percentage decrease of clot in 30 minutes (LY30). Using these values, traumatologists have developed a better, faster, and more accurate overview of a patient's resuscitation and more successfully direct blood product use. However, many orthopaedic surgeons-despite performing surgical procedures that risk notable blood loss and postoperative clotting complications-are unaware of the existence of the TEG blood test and the critical information it provides. Increasing awareness of the TEG among orthopaedic surgeons could have a notable effect on numerous aspects of musculoskeletal care.

UR - http://www.scopus.com/inward/record.url?scp=85069286391&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85069286391&partnerID=8YFLogxK

U2 - 10.5435/JAAOS-D-17-00603

DO - 10.5435/JAAOS-D-17-00603

M3 - Article

C2 - 30407978

AN - SCOPUS:85069286391

VL - 27

SP - 503

EP - 508

JO - The Journal of the American Academy of Orthopaedic Surgeons

JF - The Journal of the American Academy of Orthopaedic Surgeons

SN - 1067-151X

IS - 14

ER -