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TKA AND blood loss

Zhenyang Mao, Bing Yue, You Wang, Mengning Yan, Kerong Dai
BACKGROUND: Intra-articular injection of tranexamic acid (TXA) is known to be effective in controlling blood loss after total knee arthroplasty (TKA). However, this method has some disadvantages, such as TXA leakage due to soft tissue release. Peri-articular injection provides an alternative to intra-articular administration of TXA. This study aimed to evaluate the effects of peri-articular injection of TXA in reducing blood loss after TKA and compare them to those of intra-articular TXA injection...
October 19, 2016: BMC Musculoskeletal Disorders
Yongcai Chen, Zhuo Chen, Shuo Cui, Zhiyang Li, Zhengjiang Yuan
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug widely used to reduce blood loss during joint replacements, including total knee arthroplasty (TKA) and total hip arthroplasty (THA). However, there is no final consensus regarding the composition of an optimal administration of TXA regime between topical and systemic (intravenous). The purpose of our study was to compare the efficacy of topical and intravenous (IV) regimen of TXA during TKA and THA. METHODS: Five relevant electronic online databases, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science and Chinese Biomedical Database were systematically searched in November 2015...
October 2016: Medicine (Baltimore)
Ohannes F Plate, Andrew D Wohler, Matthew L Brown, Daniel Sun, Nora F Fino, Jason E Lang
INTRODUCTION: Stiffness and loss of motion following total knee arthroplasty (TKA) is a complex and multifactorial complication that may require manipulation under anesthesia (MUA). However, patient and surgical factors that potentially influence the development of knee stiffness following TKA are not fully understood. The purpose of this study was to identify patient and surgical factors that may influence range of motion loss following TKA by assessing a cohort of patients that underwent MUA and comparing them to a matched cohort of patients without complications...
October 6, 2016: Surgical Technology International
Jonathon Spanyer, Jay Patel, Eric Emberton, Langan S Smith, Arthur L Malkani
The purpose of this study was to evaluate the efficacy and safety profiles of topical tranexamic acid (TXA) in patients undergoing elective total knee arthroplasty (TKA) with comorbid conditions precluding them from intravenous (IV) TXA use. A total of 104 patients were divided into two groups: 47 in the normal-risk group and 57 in the high-risk group, with the latter representing those with one or more risk factors for venous thromboembolism (VTE). Demographics were similar between groups, and there were no differences with regard to postoperative changes in hemoglobin (- 3...
October 5, 2016: Journal of Knee Surgery
Jessica L Churchill, Kathleen E Puca, Elizabeth Meyer, Matthew Carleton, Michael J Anderson
Multiple studies have shown tranexamic acid (TXA) to reduce blood loss and transfusion rates in patients undergoing total knee arthroplasty (TKA). Accordingly, TXA has become a routine blood conservation agent for TKA. In contrast, ε-aminocaproic acid (EACA), a similar acting antifibrinolytic to TXA, has been less frequently used. This study evaluated whether EACA is as efficacious as TXA in reducing postoperative blood transfusion rates and compared the cost per surgery between agents. A multicenter retrospective chart review of elective unilateral TKA from April 2012 through December 2014 was performed...
October 3, 2016: Journal of Knee Surgery
Kedi Weng, Xingen Zhang, Qing Bi, Chen Zhao
OBJECTIVE: A meta-analysis was performed to investigate the effectiveness and safety of tranexamic acid (TXA) for the treatment of blood loss after a bilateral total knee arthroplasty (TKA). METHODS: Patients prepared for bilateral TKA and intervention including TXA versus placebo were comprehensively retrieved from MEDLINE (PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science from the time of the establishment of these databases to January 2016...
September 2016: Medicine (Baltimore)
Jun-Wen Wang, Bradley Chen, Po-Chun Lin, Shih-Hsiang Yen, Chung-Cheng Huang, Feng-Chih Kuo
BACKGROUND: Tranexamic acid (TXA) was reportedly to decrease postoperative blood loss after standard total knee arthroplasty (TKA). However, the blood-conservation effect of TXA in minimally invasive TKA, in particular, receiving a direct oral anticoagulant was unclear. The aim of the study was to investigate the efficacy of combined use of TXA and rivaroxaban on postoperative blood loss in primary minimally invasive TKA. METHODS: In a prospective, randomized, controlled trial, 198 patients were assigned to placebo (98 patients, normal saline injection) and study group (100 patients, 1g TXA intraoperative injection) during primary unilateral minimally invasive TKA...
August 27, 2016: Journal of Arthroplasty
Eun-Kyoo Song, Jong-Keun Seon, Jatin Prakash, Young-Jun Seol, Yong Jin Park, Cheng Jin
BACKGROUND: In this study, we tried to assess if combined method (intravenous [IV] and topical) of tranexamic acid (TXA) administration, which has been shown to be superior in conventional arthroplasty, has similar effect in navigational arthroplasty compared to administration of drug either individually. METHODS: In present randomized control trial, 200 patients were randomly divided in one of the 4 groups using computer-generated tables-control, IV, intraarticular, and combined...
July 6, 2016: Journal of Arthroplasty
Rahel Meier, Regula Marthy, Christoph H Saely, Markus S Kuster, Karlmeinrad Giesinger, Hans Rickli
INTRODUCTION: Preoperative discontinuation of aspirin (acetylsalicylic acid) can reduce bleeding risk but may increase the risk of perioperative cardiovascular events. MATERIALS AND METHODS: We retrospectively assessed the impact of preoperative continuation versus discontinuation of aspirin compared with a control group in a cohort of 739 consecutive patients undergoing total hip (THA) (n = 396) or knee arthroplasty (TKA) (n = 343) at a tertiary hospital. Bleeding risk, local complications, orthopaedic outcome, and cardiac and cerebral complications were assessed...
September 9, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Jian Li, Zhijie Zhang, Jie Chen
BACKGROUND: The study aimed to compare the effectiveness and safety of topical versus intravenous (IV) tranexamic acid (TXA) for reducing blood loss in primary total hip arthroplasty (THA). METHODS: This systematic review and meta-analysis were performed according to the preferred reporting items for systematic reviews and meta-analyses statement criteria. PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedicine Literature (CBM), Wanfang Database, China National Knowledge Infrastructure (CNKI), and Google Scholar were searched for randomized controlled trials (RCTs) and non-RCTs that compare topical versus IV-TXA administration for reducing blood loss during TKA from their inception to February, 2016...
September 2016: Medicine (Baltimore)
Anoop Jhurani, Gautam M Shetty, Vinay Gupta, Purvi Saxena, Nidhi Singh
PURPOSE: Simultaneous bilateral total knee arthroplasty (TKA) is associated with excessive blood loss and morbidity arising from postoperative reduction in hemoglobin (Hb). The purpose of this prospective randomized study was to determine if drains have any effect on blood loss, postoperative reduction in Hb levels and transfusion rates compared to no drainage in simultaneous bilateral TKAs. MATERIALS AND METHODS: Two hundred and thirty patients who underwent simultaneous bilateral TKA by a single surgeon were randomly allotted to drain or no-drain group (n=115 in each group)...
September 2016: Knee Surgery & related Research
Dong Hwi Kim, Gwang Chul Lee, Sang Hong Lee, Chi-Hyoung Pak, Sang Ha Park, Sung Jung
PURPOSE: There are many methods to reduce massive bleeding during total knee arthroplasty (TKA). In our study, tranexamic acid and neutral drainage were used to decrease total blood loss. MATERIALS AND METHODS: The study was performed on 97 TKA patients from March 2012 to January 2013. In the study group, tranexamic acid was administered and neutral drainage was applied. The study group had group I (unilateral, n=29) and group III (bilateral, n=17). The control group had group II (unilateral, n=35) and group IV (bilateral, n=16)...
September 2016: Knee Surgery & related Research
Young-Jun Seol, Jong-Keun Seon, Seung-Hun Lee, Cheng Jin, Jatin Prakash, Yong-Jin Park, Eun-Kyoo Song
PURPOSE: Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce postoperative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. MATERIALS AND METHODS: A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid...
September 2016: Knee Surgery & related Research
David Liu, Michael Dan, Sara Martinez Martos, Elaine Beller
A perioperative blood management program is one of a number of important elements for successful patient care in total knee arthroplasty (TKA) and surgeons should be proactive in its application. The aims of blood conservation are to reduce the risk of blood transfusion whilst at the same time maximizing hemoglobin (Hb) in the postoperative period, leading to a positive effect on outcome and cost. An individualized strategy based on patient specific risk factors, anticipated blood loss and comorbidities are useful in achieving this aim...
September 2016: Knee Surgery & related Research
Z F Yuan, H Yin, W P Ma, D L Xing
OBJECTIVES: Tranexamic acid (TXA) is an antifibrinolytic agent used as a blood-sparing technique in total knee arthroplasty (TKA), and is routinely administered by intravenous (IV) or intra-articular (IA) injection. Recently, a novel method of TXA administration, the combined IV and IA application of TXA, has been applied in TKA. However, the scientific evidence of combined administration of TXA in TKA is still meagre. This meta-analysis aimed to investigate the efficacy and safety of combined IV and IA TXA in patients undergoing TKA...
August 2016: Bone & Joint Research
M Dan, D Liu, S M Martos, E Beller
PURPOSE: To review records of 371 patients who underwent total hip or knee arthroplasty (THA or TKA) with intra-operative blood salvage to determine the allogeneic blood transfusion rate and the predictors for allogeneic blood transfusion. METHODS: Records of 155 male and 216 female consecutive patients aged 17 to 95 (mean, 70) years who underwent primary THA or TKA by a single surgeon with the use of intra-operative blood salvage were reviewed. RESULTS: The preoperative haemoglobin level was <120 g/dl in 15% of THA patients and 5% of TKA patients; the allogeneic transfusion rate was 24% in THA patients and 12% in TKA patients...
August 2016: Journal of Orthopaedic Surgery
Y Guzel, O T Gurcan, U H Golge, T C Dulgeroglu, H Metineren
PURPOSE: To compare the use of topical tranexamic acid (TXA) with postoperative autologous transfusion (PAT) in terms of blood loss, need for allogeneic blood transfusion, and cost-effectiveness. METHODS: Records of 25 men and 125 women (mean age, 67 years) who underwent primary unilateral total knee arthroplasty (TKA) and were randomised to the PAT group (n=50), topical TXA group (n=50), or routine drainage group (control) [n=50] were reviewed. Pre- and post-operative haemoglobin level, total postoperative drainage volume, and the need for allogeneic blood transfusion were recorded...
August 2016: Journal of Orthopaedic Surgery
Christian Skovgaard Nielsen, Kirill Gromov, Øivind Jans, Anders Troelsen, Henrik Husted
BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA. METHODS: In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet...
July 1, 2016: Journal of Arthroplasty
Jessica L Churchill, Victor A Toney, Susan Truchan, Michael J Anderson
xtensive blood loss after total knee arthroplasty (TKA) is common, and affected patients often require blood transfusions. Studies suggest that antifibrinolytic agents such as aminocaproic acid (ACA) reduce blood loss and blood transfusion rates in patients undergoing TKA. We conducted a study to evaluate whether a single intravenous 10-g dose of ACA given during primary unilateral TKA would decrease perioperative blood loss, raise postoperative hemoglobin levels, and reduce postoperative blood transfusion rates...
July 2016: American Journal of Orthopedics
Hua-chen Yu, Yu Zhang, Paul Wong
OBJECTIVE: To compare clinical efficacy of individual osteotomy instrument and total knee arthrolplasty (TKA) in treating patients with knee osteoarthritis. METHODS: From June 2014 to December 2014, 40 patients with unilateral knee osteoarthritis were randomly divided into two groups and 20 cases were in each group. One group (individual group) were treated with TKA with individual osteotomy instrument,including 5 males and 15 females with an average age of (67...
June 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
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