Archives of Orthopaedic and Trauma Surgery

, Volume 126, Issue 5, pp 335–338 | Cite as

Acute thrombotic thrombocytopenic purpura following orthopedic surgery: a case report

  • Michael I. Iosifidis
  • Merkourios Ntavlis
  • Ioannis Giannoulis
  • Leonidas Malioufas
  • Antonios Ioannou
  • Georgios Giantsis
Case Report


Thrombotic thrombocytopenic purpura (TTP) or Moschowitz’s syndrome is characterized by release of unusually large von Willebrand factor (ULvWF) multimers and a deficiency of vWF metalloprotease. It is a very rare condition, but it causes serious problems. The etiology is still unknown, although surgical stress has been associated with TTP, probably by releasing massive amounts of ULvWF. TTP is an acute, recurrent disease of the circulatory system, consisting of thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological signs, and renal dysfunction. It has the strong possibility of being fatal and thus should be treated immediately, mostly by plasmapheresis. We report a case of TTP following a high tibial valgus osteotomy. An association between TTP and orthopedic surgery—as far as we know—has only once been reported in the literature. We suggest that orthopedic surgeons should be aware of this because, although very rare, postsurgical TTP could be a life-threatening postoperative complication, which needs prompt diagnosis and treatment.


Postsurgical thrombotic thrombocytopenic purpura High tibial osteotomy 


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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Michael I. Iosifidis
    • 1
  • Merkourios Ntavlis
    • 2
  • Ioannis Giannoulis
    • 3
  • Leonidas Malioufas
    • 4
  • Antonios Ioannou
    • 5
  • Georgios Giantsis
    • 6
  1. 1.Orthopaedic DepartmentNaoussa General Hospital NaoussaThessalonikiGreece
  2. 2.Anaisthesiology DepartmentNaoussa General Hospital NaoussaAlexandriaGreece
  3. 3.Orthopaedic DepartmentNaoussa General Hospital NaoussaNaoussaGreece
  4. 4.Orthopaedic DepartmentNaoussa General Hospital, NaoussaNaoussaGreece
  5. 5.Anesthesiology DepartmentNaoussa General Hospital, NaoussaVeriaGreece
  6. 6.Orthopaedic DepartmentNaoussa General Hospital, NaoussaPanorama ThessalonikiGreece

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