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TKA AND blood loss

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https://www.readbyqxmd.com/read/28507777/the-role-of-isolated-polyethylene-exchange-in-total-knee-arthroplasty
#1
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 Rev
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28343823/process-improvement-project-using-tranexamic-acid-is-cost-effective-in-reducing-blood-loss-and-transfusions-after-total-hip-and-total-knee-arthroplasty
#11
Harry A Demos, Zilan X Lin, William R Barfield, Sylvia H Wilson, Dawn C Robertson, Vincent D Pellegrini
BACKGROUND: Tranexamic acid (TXA) has been associated with decreased blood loss and transfusion after total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to examine both transfusion utilization and the economic impact of a Process Improvement Project implementing TXA for THA and TKA. METHODS: After standardization of TXA administration in THA and TKA patients, retrospective data were compared from 12 consecutive months before (group A, n = 336 procedures) and after (group B, n = 436 procedures) project initiation...
March 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28342028/disparities-in-knee-and-hip-arthroplasty-outcomes-an-observational-analysis-of-the-acs-nsqip-clinical-registry
#12
Peter Cram, Gillian Hawker, John Matelski, Bheeshma Ravi, Andrew Pugely, Rajiv Gandhi, Timothy Jackson
BACKGROUND: Disparities in total joint arthroplasty (TJA) have largely been studied in single center studies and using administrative data. Our objective was to investigate differences in TJA outcomes in white men, black men, white women, and black women using a large international registry. METHODS: We used 2010-2013 data from the ACS-NSQIP to identify four groups of adults (white men, black men, white women, black women) who underwent primary total knee arthroplasty (TKA) or total hip arthroplasty (THA)...
March 24, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28336035/effect-of-tranexamic-acid-on-transfusion-rates-following-total-joint-arthroplasty-a-cost-and-comparative-effectiveness-analysis
#13
Perry J Evangelista, Michael W Aversano, Emmanuel Koli, Lorraine Hutzler, Ifeoma Inneh, Joseph Bosco, Richard Iorio
Tranexamic acid (TXA) is used to reduce blood loss in orthopedic total joint arthroplasty (TJA). This study evaluates the effectiveness of TXA in reducing transfusions and hospital cost in TJA. Participants undergoing elective TJA were stratified into 2 cohorts: those not receiving and those receiving intravenous TXA. TXA decreased total hip arthroplasty (THA) transfusions from 22.7% to 11.9%, and total knee arthroplasty (TKA) from 19.4% to 7.0%. The average direct hospital cost reduction for THA and TKA was $3083 and $2582, respectively...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#14
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28330800/tourniquet-and-closed-suction-drains-in-total-knee-arthroplasty-no-beneficial-effects-on-bleeding-management-and-knee-function-at-a-higher-cost
#15
D Yin, J Delisle, A Banica, A Senay, P Ranger, G Y Laflamme, J Jun, J Fernandes
BACKGROUND: Blood loss is a major concern in total knee arthroplasty (TKA) along with postoperative knee function. The present study explores the impact of tourniquet (T) and closed-suction drains (D) on these parameters in TKA. MATERIALS AND METHODS: A prospective study was conducted on 111 patients admitted for TKA. Subjects were divided into three groups: 36 in group T+D+, 42 in T-D+ and 33 in T-D- (where T+: prolonged tourniquet use, T-: cementation-only tourniquet, D+: closed-suction drain use, and D-: no drain)...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28327167/optimal-release-timing-of-temporary-drain-clamping-after-total-knee-arthroplasty
#16
RANDOMIZED CONTROLLED TRIAL
Yoon Sang Jeon, Jun Sung Park, Myung Ku Kim
BACKGROUND: Bleeding control is critical after total knee arthroplasty (TKA). The purpose of this study was to evaluate the optimal time to release the clamped drain after TKA. METHODS: We performed unilateral TKA in 120 patients using three methods of drainage. Group A (N = 40) had a 3-hour clamp applied, and group B (N = 40) had a 4-hour clamp applied. Group C (N = 40) underwent conventional negative drainage. We evaluated the drainage volume, as well as the hemodynamic markers, transfusion volume, visual analog scale (VAS) scores, and range of motion (ROM)...
March 21, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28319822/comparison-of-intravenous-versus-topical-tranexamic-acid-in-primary-total-hip-and-knee-arthroplasty-an-updated-meta-analysis
#17
REVIEW
Jinwei Xie, Qinsheng Hu, Qiang Huang, Jun Ma, Yiting Lei, Fuxing Pei
BACKGROUND: The appropriate route for administering tranexamic acid in primary total hip (THA) and knee arthroplasty (TKA) remains controversial. The purpose of this meta-analysis was to compare the efficacy and safety of topical or intravenous tranexamic acid. METHODS: PubMed, EMBASE, and the Cochrane Library databases were systematically searched for randomized controlled trials (RCTs) comparing topical and intravenous tranexamic acid following primary THA or TKA...
May 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28291435/other-benefits-of-intra-articular-injection-of-tranexamic-acid-in-primary-total-knee-arthroplasty-apart-from-reducing-blood-transfusion-rates
#18
Bahattin Kerem Aydın, Fatih Durgut, Ömer Faruk Erkoçak, Mehmet Ali Acar
OBJECTIVES: This study aims to evaluate the effect of intra-articular tranexamic acid (TA) administration on the amount of blood in the drains, the amount of blood transfusion, length of hospital stay, and the total cost in total knee arthroplasty (TKA) patients. PATIENTS AND METHODS: The study included a total of 118 patients (24 males, 94 females; mean age 67.0 years, range 52 to 81 years) who underwent primary unilateral TKA surgery. Patients were divided into two groups as 58 patients who were performed intra-articular injection of 2 g TA after closure of articular capsule (TA group; 10 males, 48 females, mean age 65...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28283902/what-is-the-ideal-route-of-administration-of-tranexamic-acid-in-tka-a-randomized-controlled-trial
#19
Sung Yup Lee, Suri Chong, Dhanasekaraprabu Balasubramanian, Young Gon Na, Tae Kyun Kim
BACKGROUND: TKA commonly involves substantial blood loss and tranexamic acid has been used to reduce blood loss after TKA. Numerous clinical trials have documented the efficacy and safety of intravenous (IV) or intraarticular (IA) use of tranexamic acid. Combined administration of tranexamic acid also has been suggested; however, there is no consensus regarding the ideal route of tranexamic acid administration. QUESTIONS/PURPOSES: (1) To compare the efficacy of tranexamic acid in terms of total blood loss and the allogeneic transfusion rate among three routes of administration: IV alone, IA alone, and combined IV and IA...
March 10, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28262452/tranexamic-acid-was-safe-in-arthroplasty-patients-with-a-history-of-venous-thromboembolism-a-matched-outcome-study
#20
Orlando D Sabbag, Matthew P Abdel, Adam W Amundson, Dirk R Larson, Mark W Pagnano
BACKGROUND: In contemporary total hip arthroplasties (THAs) and total knee arthroplasties (TKAs), intravenous tranexamic acid (IV TXA) has proved efficacious in decreasing blood loss and transfusion. Interested in expanding the use of IV TXA to patients with a prior venous thromboembolic event (VTE), we sought out to determine the risk of recurrent VTE with TXA administration during primary THA and TKA. METHODS: We retrospectively reviewed 1262 patients (1620 cases) with a history of VTE who underwent primary THA or TKA between 2000 and 2012...
February 14, 2017: Journal of Arthroplasty
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