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TKA AND blood loss

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https://www.readbyqxmd.com/read/28927562/periarticular-injection-of-tranexamic-acid-reduces-blood-loss-and-the-necessity-for-allogeneic-transfusion-after-total-knee-arthroplasty-using-autologous-transfusion-a-retrospective-observational-study
#1
Sain Yozawa, Hiroyasu Ogawa, Kazu Matsumoto, Haruhiko Akiyama
BACKGROUND: This study aimed to examine the influence of a periarticular injection of tranexamic acid (TXA) on blood loss after a total knee arthroplasty (TKA) in patients who received an autologous blood transfusion. METHODS: We retrospectively reviewed the medical charts of 82 patients (88 consecutive knees) who underwent a primary unilateral TKA with or without a periarticular TXA injection (TXA and control groups, respectively). All patients underwent an autologous blood transfusion...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28922709/non-drainage-versus-drainage-in-tourniquet-free-knee-arthroplasty-a-prospective-trial
#2
Kai Zhou, Haoyang Wang, Jinglong Li, Duan Wang, Zongke Zhou, Fuxing Pei
BACKGROUND: It is still unknown whether drainage is necessary and non-drainage is safe and acceptable after tourniquet-free total knee arthroplasty (TKA). We aim to investigate whether non-drainage use is accepted in TKA that is performed without a tourniquet. METHODS: Clinical data of 80 adult patients who did or did not receive drainage in our centres from August 2015 to December 2015 were prospective investigated. RESULTS: The drainage group exhibited reduced hidden blood loss (47...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28899856/release-of-the-tourniquet-immediately-after-the-implantation-of-the-components-reduces-the-incidence-of-deep-vein-thrombosis-after-primary-total-knee-arthroplasty
#3
P Zan, M O Mol, J J Yao, L Fan, D Yang, K Liu, G Li
AIMS: The length of the tourniquet time during total knee arthroplasty (TKA) is related to the incidence of post-operative deep vein thrombosis (DVT). Our aim in this study was to investigate the effect of the early release of the tourniquet on the incidence of DVT in patients undergoing TKA. METHODS: A total of 200 patients who underwent TKA between November 2015 and November 2016 were prospectively enrolled. The tourniquet was inflated before surgery and released immediately after the introduction of the components (early release group)...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28867520/comparison-of-the-iassist-handheld-guidance-system-to-conventional-instruments-for-mechanical-axis-restoration-in-total-knee-arthroplasty
#4
Matthew C Kinney, Krishna R Cidambi, Dustyn L Severns, Francis B Gonzales
BACKGROUND: Recent advances in total knee arthroplasty (TKA) include an intelligent instrument system designed to provide intraoperative guidance to reduce mechanical alignment errors. Internal position-sensing technology is integrated into microelectronic pods that attach to cutting blocks. The purpose of this prospective, randomized study was to determine whether this iAssist system enables the surgeon to make more accurate bone resections and better restore the mechanical axis compared to conventional instruments in TKA...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28865444/application-of-postoperative-autotransfusion-in-total-joint-arthroplasty-reduces-allogeneic-blood-requirements-a-meta-analysis-of-randomized-controlled-trials
#5
Weiping Ji, Xianfeng Lin, Ruoxia Zhang, Pan Tang, Jian Mo, Xinyi Teng, Qiuping Fan, Bo Wang, Shunwu Fan, Jianfeng Zhang, Shuai Chen, Kangmao Huang
BACKGROUND: Total joint arthroplasty is associated with significant blood loss and often requires blood transfusion. However, allogeneic blood transfusion (ABT) may lead to severe problems, such as immunoreaction and infection. Postoperative autotransfusion, an alternative to ABT, is controversial. We conducted a meta-analysis to evaluate the ability of postoperative autotransfusion to reduce the need for ABT following total knee arthroplasty (TKA) and total hip arthroplasty (THA). METHODS: Systematic literature searches for randomized controlled trials were performed using PubMed, Embase, and the Cochrane Library until February 2016...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28844765/extremely-low-transfusion-rates-contemporary-primary-total-hip-and-knee-arthroplasties
#6
Ida S Lindman, Lars V Carlsson
BACKGROUND: Considerable blood loss which requires transfusion is frequently reported after total hip and knee arthroplasties (THA and TKA). The purpose of this study is to review the transfusion rates in contemporary THA and TKA with optimized perioperative protocols including minimized surgical trauma and optimal perioperative patient care. METHODS: This retrospective study included 1442 consecutive patients receiving either a primary THA or a TKA from the same high-volume surgeon between January 2008 and December 2015...
July 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28827053/bilateral-simultaneous-unicompartmental-knee-arthroplasty-versus-unilateral-total-knee-arthroplasty-a-comparison-of-the-amount-of-blood-loss-and-transfusion-perioperative-complications-hospital-stay-and-functional-recovery
#7
J H Ahn, D M Kang, K J Choi
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is a good alternative treatment option to total knee arthroplasty (TKA) for single compartment knee osteoarthritis. Several recent reports suggest that UKA results in more rapid functional recovery than TKA, together with fewer complications. Few performed a comparison of bilateral simultaneous UKA and unilateral TKA. HYPOTHESIS: Bilateral simultaneous UKA would result in fewer perioperative complications, less blood loss, less transfusion and faster recovery of short-term clinical outcomes, compared with unilateral TKA patients...
August 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28792707/limitations-of-preoperative-pfa-200-as-a-predictor-of-postoperative-blood-loss-in-total-knee-arthroplasty-according-to-use-of-tranexamic-acid
#8
You La Jeon, Woo-In Lee, So Young Kang, Myeong Hee Kim
BACKGROUND: Recently, anti-fibrinolytic agents (tranexamic acid) have been used to reduce blood loss or and the need for transfusion. We evaluated the clinical utility of PFA-200 as a predictor of postoperative blood loss in a clinical setting, where hemostasis can be affected by variables such as existing comorbidities and medication use. METHODS: We analyzed retrospectively 243 TKA patients having PFA-200 results between March 2014 and May 2016. We collected the medication history of anti-thrombotic agents, closure time measured by PFA-200, postoperative drainage volume, and perioperative change of hemoglobin values...
July 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28768781/usefulness-of-an-accelerometer-based-portable-navigation-system-in-total-knee-arthroplasty
#9
RANDOMIZED CONTROLLED TRIAL
T Ikawa, S Takemura, M Kim, K Takaoka, Y Minoda, Y Kadoya
AIMS: The aim of this study was to evaluate the effects of using a portable, accelerometer-based surgical navigation system (KneeAlign2) in total knee arthroplasty (TKA) on the alignment of the femoral component, and blood loss. PATIENTS AND METHODS: A total of 241 consecutive patients with primary osteoarthritis of the knee were enrolled in this prospective, randomised controlled study. There were 207 women and 34 men. The mean age of the patients was 74.0 years (57 to 89)...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28755884/comparison-of-oral-versus-intravenous-application-of-tranexamic-acid-in-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#10
REVIEW
Lu-Kai Zhang, Jian-Xiong Ma, Ming-Jie Kuang, Jie Zhao, Ying Wang, Bin Lu, Lei Sun, Xin-Long Ma
BACKGROUND: Tranexamic acid (TXA) is regarded as one of the most important drugs in reducing blood loss and hemoglobin (Hb) drop after total knee arthroplasty (TKA) or total hip arthroplasty (THA). Treatment with tranexamic acid (TXA) by intravenous application has been discussed extensively. Recently, several studies have reported that oral administration has an effect on blood sparing. Therefore, we performed a meta-analysis to investigate the efficacy and safety between oral TXA and intravenous TXA (IV-TXA) for blood sparing in total knee and hip arthroplasty...
July 26, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28746213/is-combined-topical-and-intravenous-tranexamic-acid-superior-to-single-use-of-tranexamic-acid-in-total-joint-arthroplasty-a-meta-analysis-from-randomized-controlled-trials
#11
REVIEW
Liqing Yang, Shuai Du, Yuefeng Sun
BACKGROUND: To compare the efficacy and safety of the combined application of both intravenous and topical tranexamic acid (TXA) versus the single use of either application in patients with total knee and hip arthroplasty (TKA and THA). METHODS: Potentially relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, and the Cochrane Library. Randomized control trials (RCTs) of patients prepared for total joint arthroplasty that compared combined TXA with placebo were retrieved...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28742015/topical-tranexamic-acid-reduces-transfusion-rates-in-simultaneous-bilateral-total-knee-arthroplasty-a-retrospective-case-series
#12
Christopher Kim, Sam S Park, Herman S Dhotar, Anthony V Perruccio, Michael G Zywiel, J Roderick Davey
BACKGROUND: Topical tranexamic acid (TA) has been reported to be effective in reducing postoperative bleeding and transfusions after TKA. The main objective of this study was to retrospectively assess the effectiveness and safety of topical TA administration in patients undergoing simultaneous bilateral TKA. METHODS: We conducted a retrospective chart review of consecutive cohorts of patients undergoing simultaneous bilateral TKA. We compared the patients who received TA with patients from a similar time frame who did not receive TA...
August 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28723749/effects-of-sealing-the-intramedullary-femoral-canal-in-total-knee-arthroplasty-a-randomized-study
#13
RANDOMIZED CONTROLLED TRIAL
Xu Li, Xiang-Bei Qi, Xue Han, Wei Wang, Jian-Ning Liu, Ji-Chao Guo, Zhi-Yong Li
BACKGROUND: This study investigates the clinical effects of sealing the femoral canal by intramedullary alignment instrumentation in total knee arthroplasty (TKA). METHODS: One hundred twenty consecutive patients with knee osteoarthritis, who underwent unilateral TKA, were enrolled in the study and equally randomized into 2 groups: the sealing group and the control group. In the sealing group, the femoral canal was sealed with autogenous bone and cement using intramedullary alignment instrumentation, while the femoral hole was left open for patients in the control group...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28697863/intra-articular-application-is-more-effective-than-intravenous-application-of-tranexamic-acid-in-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#14
Jin Wang, Qiaojie Wang, Xianlong Zhang, Qi Wang
BACKGROUND: The optimal administration route of tranexamic acid (TXA) in total knee arthroplasty (TKA), and the effect of TXA on hidden blood loss and total blood loss are undetermined. The purpose of this study was to compare the effectiveness of intravenous versus intra-articular application of tranexamic acid in patients undergoing knee arthroplasty. METHODS: A total of 150 patients undergoing primary unilateral total knee arthroplasty were randomly distributed to 3 groups (IV, intra-articular, and control group; each 50 patients) and administrated TXA (1 g IV and 50 mL intra-articular saline, 1 g intra-articularly and 50 mL intra-articular saline, and 0 g and 50 mL intra-articular saline, respectively)...
June 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28662956/tranexamic-acid-in-knee-surgery-study-a-multicentered-randomized-controlled-trial
#15
Marinus D J Stowers, James Aoina, Andrew Vane, Vaughan Poutawera, Andrew G Hill, Jacob T Munro
BACKGROUND: Postoperative anemia following elective arthroplasty can lead to prolonged hospital stay and delays in rehabilitation and is often poorly tolerated in patients with cardiovascular disease. Tranexamic acid (TXA) has been shown to reduce perioperative blood loss in total knee arthroplasty (TKA). However, questions over its optimal route of administration remain. METHODS: A double-blinded, placebo, multicentered, randomized, controlled trial investigating the efficacy of topical and systemic routes of a single intraoperative dose (1...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28658157/efficacy-of-tranexamic-acid-plus-drain-clamping-to-reduce-blood-loss-in-total-knee-arthroplasty-a-meta-analysis
#16
REVIEW
Yan Zhang, Jun-Wei Zhang, Bao-Hua Wang
BACKGROUND: Perioperative blood loss is still an unsolved problem in total knee arthroplasty (TKA). The efficacy of the preoperative use of tranexamic acid (TXA) plus drain-clamping to reduce blood loss in TKA has been debated. This meta-analysis aimed to illustrate the efficacy of TXA plus drain-clamping to reduce blood loss in patients who underwent a TKA. METHODS: In February 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28658120/the-effect-of-platelet-rich-plasma-on-reducing-blood-loss-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#17
REVIEW
Jinhui Ma, Jiale Sun, Wanshou Guo, Zirong Li, Bailiang Wang, Weiguo Wang
BACKGROUND: Efficacy and safety of platelet-rich plasma (PRP) compared with control for preventing postoperative bleeding after total knee arthroplasty (TKA) is controversial. We performed a meta-analysis of randomized controlled trials (RCTs) to determine whether PRP might reduce blood loss and improve function following TKA. METHODS: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify RCTs comparing PRP with control for patients undergoing unilateral TKA...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28637438/the-efficacy-and-safety-of-tranexamic-acid-in-revision-total-knee-arthroplasty-a-meta-analysis
#18
Peng Tian, Wen-Bin Liu, Zhi-Jun Li, Gui-Jun Xu, Yu-Ting Huang, Xin-Long Ma
BACKGROUND: There is no consistent conclusion regarding the efficacy and safety of the intravenous administration of tranexamic acid (TXA) for reducing blood loss in revision total knee arthroplasty (TKA). We performed a meta-analysis of comparative trials to evaluate the efficacy and safety of TXA in revision TKA. METHODS: We conducted a search of PubMed, EMBASE, The Cochrane Library and Web of Science for randomized controlled trials (RCTs) and non-RCTs. Two authors selected the studies, extracted the data, and assessed the risk of bias independently...
June 21, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28614226/tranexamic-acid-plus-diluted-epinephrine-versus-tranexamic-acid-alone-for-blood-loss-in-total-joint-arthroplasty-a-meta-analysis
#19
REVIEW
Zhanxia Yu, Lulan Yao, Qin Yang
BACKGROUND: We conducted the present meta-analysis to assess the efficacy and safety of tranexamic acid (TXA) plus diluted-epinephrine (DEP) for patients with total joint arthroplasty (TJA, including total knee arthroplasty (TKA) and total hip arthroplasty (THA)). METHODS: Electronic databases (PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Chinese Wanfang databases, and Google databases) were systematically searched up to December 2016...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28580500/vascular-calcifications-on-the-preoperative-radiograph-harbinger-of-tourniquet-failure-in-patients-undergoing-total-knee-arthroplasty
#20
Julia Verena Woelfle-Roos, Laura Dautel, Benjamin Mayer, Ralf Bieger, Klaus-Dieter Woelfle, Heiko Reichel
OBJECTIVE: Vascular calcifications on the preoperative radiograph of patients scheduled for total knee arthroplasty (TKA) often give rise to concern, as their clinical relevance remains uncertain. The aim of this study was to investigate whether these vascular calcifications-especially medial artery calcifications (MACs), which increase arterial stiffness-were associated with tourniquet failure and thus with increased intraoperative blood loss. MATERIALS AND METHODS: A total of 765 patients who underwent primary TKA with a tourniquet (cuff pressure 350 mmHg) between 2009 and 2011 were screened for vascular calcifications on the preoperative radiograph...
September 2017: Skeletal Radiology
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