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TKA AND blood loss

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
June 5, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28567578/the-efficacy-and-safety-of-multiple-dose-intravenous-tranexamic-acid-on-blood-loss-following-total-knee-arthroplasty-a-randomized-controlled-trial
#8
Yiting Lei, Jinwei Xie, Bin Xu, Xiaowei Xie, Qiang Huang, Fuxing Pei
PURPOSE: To assess the efficacy and safety of multiple-dose intravenous tranexamic acid (IV-TXA) on blood loss following total knee arthroplasty (TKA). METHODS: One hundred fifty nine patients received one bolus of IV-TXA before skin incision and two boluses three and six hours later (group A), or another bolus nine hours later (group B), or another two boluses nine and 12 hours later (group C). The primary outcomes were total blood loss (TBL), hidden blood loss (HBL), and maximum haemoglobin (Hb) drop...
May 31, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28553440/prospective-study-to-compare-intra-articular-versus-intravenous-tranexemic-acid-in-reducing-post-operative-blood-loss-in-staged-bilateral-total-knee-arthroplasty
#9
N Balasubramanian, G B Natarajan, S Prakasam
The number of total knee arthroplasties (TKA) performed is around two million annually worldwide and this number is expected to increase fivefold by 2025. The most common indication is osteoarthritis of the knee. Blood loss is significant during the post-operative period and blood transfusion when necessary has its own drawbacks. The use of intravenous tranexamic acid has significantly reduced blood loss. We analysed 35 patients who underwent staged bilateral TKA between August 2013 and February 2016 and had administered intra-articular tranexamic acid for one knee and intravenous tranexamic acid for the other knee...
November 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28544490/evaluation-of-outcomes-of-suction-drainage-in-patients-with-haemophilic-arthropathy-undergoing-total-knee-arthroplasty
#10
S M J Mortazavi, M A Firoozabadi, A Najafi, P Mansouri
INTRODUCTION: Closed suction drainage has been extensively applied for orthopaedic procedures for the sake of avoiding fluid collections around the wound at the operated limb. AIM: We believed that without application of suction drainage after total knee arthroplasty (TKA), the risk of infection and haematoma formation will not increase while the need for blood transfusion because of decreased blood loss will be lesser. METHODS: In a prospective randomized clinical trial from April 2010 to April 2014, 176 patients with haemophilia who underwent TKA were included...
May 24, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28507777/the-role-of-isolated-polyethylene-exchange-in-total-knee-arthroplasty
#11
REVIEW
Hee-Nee Pang, Hamid Rahmatullah Bin Abd Razak, Stephen Petis, Douglas D R Naudie, Steven J MacDonald
The use of modular total knee arthroplasty (TKA) implants allows surgeons to perform isolated tibial polyethylene insert exchange (IPE) while retaining well-fixed and stable components.The purported advantages of IPE include preservation of bone stock, shorter operating time, less blood loss, faster rehabilitation and lower cost. However, the indications for IPE are limited.IPE for wear and osteolysis has moderate success in the medium term but should be avoided in cases of accelerated wear. In selected cases, debridement and IPE for early infection can result in low morbidity with high success rates in the short term...
March 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28507566/comparison-of-intra-articular-versus-intravenous-application-of-tranexamic-acid-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Yaming Liu, Fantao Meng, Gang Yang, Lingde Kong, Yong Shen
INTRODUCTION: There is much controversy about the optimal application of tranexamic acid (TXA) in total knee arthroplasty (TKA). The purpose of this meta-analysis was to compare the efficacy of the intra-articular and intravenous regimens of TXA in TKA. MATERIAL AND METHODS: A literature search of the PubMed, Embase and Cochrane Library databases was performed. Randomized controlled trials comparing the result of intra-articular and intravenous application of TXA during TKA were included...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28470576/a-comparative-analysis-of-the-role-of-tranexamic-acid-as-an-independent-variable-in-reducing-intraoperative-blood-loss-in-patients-undergoing-conventional-total-knee-arthroplasty-versus-computer-assisted-total-knee-arthroplasty
#13
K K Eachempati, A V Gurava Reddy, S Apsingi, S R Sankineani, J Shaheed, C Dannana
BACKGROUND: Blood loss in total knee arthroplasty (TKA) is an area of significant concern as it has an effect on patient morbidity and hospital stay. Among many different modalities to reduce blood loss, the use of Tranexamic acid has become a standard procedure nowadays. The aim of our study was to determine if Tranexamic acid alone decreases blood loss as an independent variable irrespective of other blood loss preserving measures. METHOD: This prospective non-randomized study included patients undergoing unilateral TKA by conventional method (Group 1) and computer-assisted TKA (Group 2)...
May 3, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28448319/tranexamic-acid-reduces-blood-loss-and-transfusion-requirements-in-primary-simultaneous-bilateral-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#14
Yuangang Wu, Timin Yang, Yi Zeng, Haibo Si, Canfeng Li, Bin Shen
: The aim of this meta-analysis is to assess the effectiveness and safety of intravenous application tranexamic acid (TXA) in primary simultaneous bilateral total knee arthroplasty (TKA). We searched electronic databases including PubMed, Embase, the Web of Science, the Cochrane Library and the Google Scholar, for published studies involving the intravenous application TXA in primary simultaneous bilateral TKA. All randomized controlled trials were included. The focus of the meta-analysis was on the outcomes of total blood loss, drainage volume, transfusion requirements and deep venous thrombosis (DVT) and/or pulmonary embolism...
April 26, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28445317/timing-of-tourniquet-release-in-total-knee-arthroplasty-a-meta-analysis
#15
REVIEW
Pei Zhang, Yuan Liang, Jinshan He, Yongchao Fang, Pengtao Chen, Jingcheng Wang
BACKGROUND: For total knee arthroplasty (TKA), the tourniquet is routinely employed for better visualization, less blood loss, and easier cementation. However, the time to release tourniquet remains controversial. Therefore, we performed current meta-analysis to assess whether releasing tourniquet before wound closure is more effective in reducing blood loss than releasing tourniquet after wound closure in TKA without an increased risk of complications. METHODS: To conduct this meta-analysis, we searched Medline, Embase, Web of science, and the Cochrane library up to November 2016, for randomized controlled trials comparing tourniquet releasing before and after wound closure in TKA...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420413/is-combined-use-of-intravenous-and-intraarticular-tranexamic-acid-superior-to-intravenous-or-intraarticular-tranexamic-acid-alone-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#16
Bobin Mi, Guohui Liu, Huijuan Lv, Yi Liu, Kun Zha, Qipeng Wu, Jing Liu
BACKGROUND: Tranexamic acid (TXA) has been proven to be effective in reducing blood loss and transfusion rate after total knee arthroplasty (TKA) without increasing the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Recently, an increasing number of studies have been interested in applying combined intravenous (IV) with intraarticular (IA) tranexamic acid in total knee arthroplasty. The purpose of this meta-analysis was to compare the blood loss and complications of combined TXA with IV TXA or IA TXA on TKA...
April 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28395389/tranexamic-acid-and-computer-assisted-surgery-in-cemented-and-cementless-total-knee-arthroplasty-are-the-effects-additive-for-blood-conservation
#17
Michael Fleischman, Mark Hood, Mary Ziemba-Davis, R Michael Meneghini
INTRODUCTION: Efforts continue to minimize blood loss associated with total knee arthroplasty (TKA). The primary objective of this study was to determine whether computer-assisted surgery (CAS) and tranexamic acid (TXA) were additive in minimizing blood loss in cemented TKA. The secondary objective was to assess the combined effectiveness of CAS and TXA in cementless TKA. MATERIALS AND METHODS: A retrospective study of 393 consecutive primary TKAs with cemented and cementless fixation was performed...
April 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28395370/intra-articular-tranexamic-acid-in-primary-total-knee-arthroplasty-meta-analysis
#18
Joseph T Moskal, Susan G Capps
Total knee arthroplasty (TKA) is associated with an increased need for blood transfusions and thus an increase in risks associated with blood transfusion such as transfusion reactions, infections, fluid overload, and altered mental status. Tranexamic acid (TXA) is an antifibrinolytic medication that can reduce perioperative blood loss in TKA. However, the best method of delivery has not been defined although topical intra-articular TXA (IA-TXA) may have a theoretical advantage as it is applied directly when and where it is needed to control bleeding...
April 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28385937/multimodal-infiltration-of-local-anaesthetic-in-total-knee-arthroplasty-is-posterior-capsular-infiltration-worth-the-risk-a-prospective-double-blind-randomised-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
P Pinsornsak, S Nangnual, K Boontanapibul
AIMS: Multimodal infiltration of local anaesthetic provides effective control of pain in patients undergoing total knee arthroplasty (TKA). There is little information about the added benefits of posterior capsular infiltration (PCI) using different combinations of local anaesthetic agents. Our aim was to investigate the effectiveness of the control of pain using multimodal infiltration with and without infiltration of the posterior capsule of the knee. PATIENTS AND METHODS: In a double-blind, randomised controlled trial of patients scheduled for unilateral primary TKA, 86 were assigned to be treated with multimodal infiltration with (Group I) or without (Group II) PCI...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28378211/intra-articular-versus-intravenous-tranexamic-acid-application-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#20
Bobin Mi, Guohui Liu, Wu Zhou, Huijuan Lv, Yi Liu, Kun Zha, Qipeng Wu, Jing Liu
BACKGROUND: The purpose of this meta-analysis was to compare the blood loss and complications of intra-articular (IA) with intravenous (IV) tranexamic acid (TXA) for total knee arthroplasty (TKA). METHODS: A comprehensive search of studies was conducted to identify related articles in Pubmed, Embase, Cochrane central Register of Controlled Trials, springerLink, OVID and the Research published from January 1980 to September 2016. All studies that compared IA TXA with IV TXA application on TKA were included...
April 4, 2017: Archives of Orthopaedic and Trauma Surgery
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