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TKA AND blood loss

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https://www.readbyqxmd.com/read/29352682/are-allogeneic-transfusions-decreasing-in-total-knee-arthroplasty-patients-national-inpatient-sample-2009-2013
#1
Jaydev B Mistry, Chukwuweike U Gwam, Qais Naziri, Robert Pivec, Roby Abraham, Michael A Mont, Ronald E Delanois
BACKGROUND: Allogeneic transfusions are commonly used for substantial blood loss in total knee arthroplasty (TKA), but have been associated with adverse effects and increased costs. The purpose of this study is to provide a detailed description of (1) trends of allogeneic blood transfusion; (2) risk factors and adverse events; and (3) discharge disposition, length-of-stay (LOS), and cost/charge analysis for primary TKA patients who received an allogeneic blood transfusion from 2009-2013...
December 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29343449/the-comparative-efficacy-and-safety-of-topical-and-intravenous-tranexamic-acid-for-reducing-perioperative-blood-loss-in-total-knee-arthroplasty-a-randomized-controlled-non-inferiority-trial
#2
Jefferson George, Krishna Kiran Eachempati, Koushik Narayan Subramanyam, A V Gurava Reddy
BACKGROUND: Total Knee Arthroplasty (TKA) can be associated with significant perioperative blood loss and blood transfusions. This is a prospective randomised non-inferiority trial comparing intraarticular (IA) and intravenous (IV) routes of administering Tranexamic acid (TXA) with regard to efficacy and safety. METHODS: A total of 113 patients who underwent primary unilateral TKA from January to June 2017 randomly received either 1.5g TXA in 100mL normal saline solution (IA group, n=58) or 10mg/kg TXA (IV group, n=55) at 10min before the tourniquet inflation and at tourniquet release...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29343282/investigation-of-perioperative-safety-and-clinical-results-of-one-stage-bilateral-total-knee-arthroplasty-in-selected-low-risk-patients
#3
Hirotaka Mutsuzaki, Arata Watanabe, Tetsuya Komatsuzaki, Tomonori Kinugasa, Kotaro Ikeda
BACKGROUND: An increased perioperative complication rate has been a concern with one-stage bilateral total knee arthroplasty (TKA). The purpose of this study was to retrospectively investigate the perioperative safety and clinical results of one-stage bilateral TKA in selected low-risk patients. METHODS: Sixty-seven patients who received one-stage bilateral TKAs for osteoarthritis who were American Society of Anesthesiology (ASA) class 1 or 2 were included in this study...
January 17, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29325462/tocilizumab-treatment-in-patients-with-rheumatoid-arthritis-is-associated-with-reduced-fibrinogen-levels-and-increased-blood-loss-after-total-knee-arthroplasty
#4
Hitoshi Imamura, Shigeki Momohara, Koichiro Yano, Yu Sakuma, Masanori Nakayama, Haruki Tobimatsu, Katsunori Ikari
OBJECTIVE: Because IL-6 has been associated with activation of the coagulation cascade and upregulation of fibrinogen transcription, we retrospectively tested the hypothesis that patients with rheumatoid arthritis (RA) treated with tocilizumab (TCZ) may lose more blood when undergoing total knee arthroplasty (TKA). METHODS: This study included 115 RA patients who underwent primary TKA and were preoperatively tested for fibrinogen levels. The blood volume of each patient was calculated using the Nadler formula, and estimated blood loss after TKA was calculated as the change between preoperative and postoperative hematocrits...
January 11, 2018: Modern Rheumatology
https://www.readbyqxmd.com/read/29286032/-bidirectional-knotless-barbed-sutures-during-primary-total-knee-arthroplasty-effective-solution-or-new-problem
#5
D V Chugaev, N N Kornilov, S A Lasunskii
THE HYPOTHESIS OF THE STUDY: The use of bidirectional knotless barbed sutures for closure of capsule and subcutaneous fat tissue in primary total knee arthroplasty (TKA) is safe and time-saving. MATERIAL AND METHODS: 302 patients with end-stage osteoarthritis scheduled for primary non-complex TKA were randomly divided into two prospective groups: in group I (N=102) the capsule of the knee joint and subcutaneous fat tissues were closed by continuous braided suture while in group II (N=200) by bidirectional knotless barbed sutures...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29245293/association-of-tourniquet-utilization-with-blood-loss-rehabilitation-and-complications-in-chinese-obese-patients-undergoing-total-knee-arthroplasty-a-retrospective-study
#6
Zhirui Li, Daohong Liu, Gong Long, Gong Ke, An Xiao, Peifu Tang, Jiyuan Dong
Obesity not only gives rise to more blood loss volume but also correlates with postoperative rehabilitation and complications in surgical patients. It is not clear at present whether tourniquet utilization is associated with blood loss, rehabilitation, and complications, and it is imperative to ascertain the tactics of utilizing tourniquet in obese patients undergoing total knee arthroplasty (TKA). The present study was designed to explore the association of tourniquet utilization with blood loss, rehabilitation, and complications, and ascertain the tactics of utilizing tourniquet in obese patients undergoing TKA...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29204503/bicompartmental-knee-arthroplasty-vs-total-knee-arthroplasty-for-the-treatment-of-medial-compartment-and-patellofemoral-osteoarthritis
#7
Sahil Kooner, Herman Johal, Marcia Clark
Background: Interest in bicompartmental knee arthroplasty (BKA) for the treatment of medial patellofemoral osteoarthritis (MPFOA) has grown in recent years because BKA offers a bone and ligament-preserving alternative to total knee arthroplasty (TKA). BKA only resurfaces the diseased compartments, while preserving proprioception and native knee kinematics. Therefore, the objective of this study is to assess knee function, perioperative morbidity, and implant survivability in patients undergoing BKA vs TKA for MPFOA...
December 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/29201870/factors-that-influence-blood-loss-and-need-for-transfusion-following-total-knee-arthroplasty
#8
Achilleas Boutsiadis, Ryan Jacob Reynolds, Mo Saffarini, Jean-Claude Panisset
Background: Blood loss during total knee arthroplasty (TKA) remains a concern, as many patients require blood transfusions, which increase risks of allergic reactions, disease transmission, and thromboembolisms. The purpose was to determine factors associated with blood loss and need for transfusion in patients receiving routine TKA. Methods: The authors prospectively analyzed 150 consecutive uncemented TKAs for age, gender, body mass index (BMI), anticoagulant medication, type of anesthesia, tranexamic acid (TXA) administration, tourniquet inflation, drain placement, pre- and post-operative Haemoglobin (Hb) level (g/dL), and whether transfusion was necessary...
November 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29199379/mini-subvastus-versus-medial-parapatellar-approach-for-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#9
Ziyu Li, Wendan Cheng, Liangye Sun, Yunfeng Yao, Qiliang Cao, Shuming Ye, Lei Qi, Shenglin Xu, Xiaosan Wu, Juehua Jing
PURPOSE: Whether minimally invasive total knee arthroplasty (MIS-TKA) could offer better and faster recovery without the deviation of post-operative prosthesis position and limb alignment is still controversial. This prospective and randomized study was conducted to compare the clinical and radiological outcomes between patients who underwent the mini-subvastus approach of MIS-TKA and those who underwent the medial parapatellar approach of traditional TKA. METHODS: Fifty patients, including 50 knees, who required TKA due to osteoarthritis were randomized to the mini-subvastus group (group I) or the medial parapatellar group (group II)...
December 4, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29180326/-total-knee-arthroplasty-with-3d-printing-technique-versus-conventional-surgery-comparison-of-the-outcomes
#10
Ming Niu, Fei Ma, Ju-Rong Ma, Jun-Wei Li, Xu-Nian Wu, Tong Wang, Yu-Liang Wang
OBJECTIVE: To compare the clinical outcomes of patients receiving total knee arthroplasty (TKA) using 3D printing technique and conventional surgical methods. METHODS: From October, 2015 to February, 2017, 17 patients (20 knees) underwent TKA with the assistance of individualized navigation template and 16 concurrent patients (18 knees) matched for age, gender and knee society score received conventional TKA. The operation time, blood loss, and osteotomy data of the femoral condyle and tibia plateau were recorded...
November 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/29137681/influence-of-tourniquet-use-in-primary-total-knee-arthroplasty-with-drainage-a-prospective-randomised-controlled-trial
#11
Kai Zhou, Tingxian Ling, Haoyang Wang, Zongke Zhou, Bin Shen, Jing Yang, Pengde Kang, Fuxing Pei
BACKGROUND: We aimed to compare the effect of tourniquet use or lack of it on recovery following uncomplicated primary total knee arthroplasty (TKA). METHODS: In a prospective randomised double-blinded study, 150 patients undergoing primary TKA were assigned to either a tourniquet or non-tourniquet group. At the early phase, 3 and 6 months after surgery, an independent observer assessed the primary outcome measure (i.e. total blood loss) and secondary outcome measures (i...
November 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29078788/the-efficacy-of-tranexamic-acid-using-oral-administration-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#12
Lu-Kai Zhang, Jian-Xiong Ma, Ming-Jie Kuang, Jie Zhao, Bin Lu, Ying Wang, Xin-Long Ma, Zheng-Rui Fan
BACKGROUND: Total knee arthroplasty (TKA) is gradually regarded as an effective choice for end-stage osteoarthritis or rheumatic arthritis. In the past, the management of tranexamic acid (TXA) using intravenous injection or topical application has been extensively researched. However, several studies have reported that oral TXA has an effect on blood loss. Therefore, a meta-analysis should be performed to determine whether oral TXA helps to prevent blood loss. METHODS: Randomized controlled trials or retrospective cohort studies about relevant studies were searched in PubMed (1996-April 2017), Embase (1980-April 2017), and the Cochrane Library (CENTRAL, April 2017)...
October 27, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29050180/-meta-analysis-of-three-dimensional-printing-patient-specific-instrumentation-versus-conventional-instrumentation-in-total-knee-arthroplasty
#13
J T Ren, C Xu, J S Wang, X L Liu
Objective: To evaluate the effects of three-dimensional printing patient-specific instrumentation(PSI) versus conventional instrumentation(CI) in the total knee arthroplasty. Methods: According to "patient-specific" , "patient-matched" , "custom" , "Instrumentation" , "Guide Instrumentation" , "cutting blocks" , "total knee arthroplasty" , "total knee replacement" , "TKA" and "TKR" , the literature on PubMed, EMbase, Cochrane library, CBM and WanFang were searched. According to the inclusion and exclusion criteria, the high quality randomized control trial (RCT) studies about three-dimensional (3D) printing patient-specific instrumentation versus conventional instrumentation in the total knee arthroplasty were collected...
October 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29049195/the-efficacy-of-combined-intra-articular-and-intravenous-tranexamic-acid-for-blood-loss-in-primary-total-knee-arthroplasty-a-meta-analysis
#14
REVIEW
Zhao Wang, Xiaofei Shen
BACKGROUND: This meta-analysis aimed to illustrate the efficacy and safety of combined topical and intravenous (IV) tranexamic acid (TXA) for blood loss control in primary total knee arthroplasty (TKA) patients. METHODS: In April 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, Cochrane Database of Systematic Reviews, and Google database. Data on patients prepared for TKA surgery in studies that compared combined topical and IV TXA versus placebo, topical, or IV TXA alone were retrieved...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29039330/comparison-of-tranexamic-acid-pharmacokinetics-after-intra-articular-and-intravenous-administration-in-rabbits
#15
Gen-Xiang Rong, Chen-Lin Shen, Bin-Jie Gui, Hao Yin, Zhi Tang
Tranexamic Acid (TXA) is commonly administered in total knee arthroplasty for reducing blood loss. There has been a growing interest in the topical use of TXA except intravenous use for prevention of bleeding in TKA. The aim of this study was to develop and validate a HPLC-MS method to detect TXA and apply to compare the pharmacokinetic profile of TXA after intravenous (IV) and topical intra-articular (IA) application of TXA at a dose of 20 mg/kg in rabbits. In order to prove intra-articular administration is better than that of intravenous administration from the point of rabbit pharmacokinetic...
July 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28980475/comparison-of-oral-and-intravenous-tranexamic-acid-for-prevention-of-perioperative-blood-loss-in-total-knee-and-total-hip-arthroplasty
#16
Mary Alice Gortemoller, Bryan Allen, Rochelle Forsyth, Kimberly Theiss, Kristal Cunningham, Calvin Tucker
BACKGROUND: Tranexamic acid (TA) is an antifibrinolytic agent that prevents perioperative blood loss in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). This benefit has been established with the intravenous (IV) dosage form, but there is limited evidence evaluating oral TA in this setting. OBJECTIVE: To compare the effect of oral versus IV TA on perioperative blood loss in those undergoing TKA or THA. METHODS: In this single-centered retrospective chart review, participants at least 18 years of age who received IV or oral TA from a single surgeon who performed their THA or TKA were included...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28976426/blood-conservation-using-tranexamic-acid-is-not-superior-to-epsilon-aminocaproic-acid-after-total-knee-arthroplasty
#17
RANDOMIZED CONTROLLED TRIAL
Clifford Kent Boese, Leslie Centeno, Ryan W Walters
BACKGROUND: Epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA) are synthetic amino acid derivatives that interfere with fibrinolysis, promoting hemostasis by pharmacological means. Although both drugs have been shown to decrease blood loss with a minimal risk of thromboembolic adverse events following cardiac and vascular surgery, we are aware of only 1 published trial that directly compared the antifibrinolytic effects of EACA with those of TXA after total knee arthroplasty (TKA)...
October 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28968480/topically-applied-epsilon-aminocaproic-acid-reduces-blood-loss-and-length-of-hospital-stay-after-total-knee-arthroplasty
#18
Robert A Harper, Mark G Sucher, Mauro Giordani, Alexander J Nedopil
Perioperative blood loss after total knee arthroplasty (TKA) affects postoperative recovery. Tranexamic acid is safe and efficient in reducing blood loss without increasing thromboembolic events. Epsilon-aminocaproic acid (ε-ACA) is less expensive than and as safe as tranexamic acid. Its efficiency when locally applied in TKA is unknown. The authors retrospectively followed 240 consecutive patients treated by 1 surgeon with TKA from January 2012 to August 2016. From January 2013 to May 2015, the authors topically applied 5 g of ε-ACA to the open wound after tourniquet release and before closure (ε-ACA-after-tourniquet-release group)...
October 2, 2017: Orthopedics
https://www.readbyqxmd.com/read/28956171/the-baba-classification-focused-on-implant-designs-is-useful-in-setting-the-therapeutic-strategy-for-interprosthetic-femoral-fracture
#19
Tomonori Baba, Kazuo Kaneko, Yasuhiro Homma, Hironori Ochi, Yu Ozaki, Taiji Watari, Mikio Matsumoto
PURPOSE: The purpose of this study was to investigate the clinical outcomes of femoral fracture with implants on the proximal and distal sides to verify whether actual fracture morphologies follow the fracture types of Baba classification focusing on implant designs useful for periprosthetic femoral fracture. METHODS: Prosthesis was present in 85 with periprosthetic femoral fractures. Excluding 73 patients with fracture around the femoral stem or fracture of the TKA femoral component alone, 12 patients with 14 legs with both implants were investigated...
September 27, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28943099/a-systematic-review-of-the-effects-of-platelet-rich-plasma-on-outcomes-for-patients-with-knee-osteoarthritis-and-following-total-knee-arthroplasty
#20
REVIEW
Tendai Aswad Muchedzi, Simon B Roberts
INTRODUCTION: Platelet rich plasma (PRP) has been suggested to be effective in the management of knee osteoarthritis. Review of current literature reveals conflicting evidence regarding the benefits of PRP in treating knee OA. Preclinical evidence supports the use of PRP injections to promote a favorable environment for joint tissue healing, targeting not only cartilage but also synovial and meniscal tissues which has a positive effect on delaying the progression of OA. Growth factors found in platelet granules are postulated to influence outcomes in knee OA and after total knee arthroplasty (TKA)...
September 21, 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
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