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TKA AND blood loss

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https://www.readbyqxmd.com/read/28238584/perioperative-and-early-postoperative-comparison-of-a-modern-cemented-and-cementless-total-knee-arthroplasty-of-the-same-design
#1
Denis Nam, Judith E Kopinski, Zachary Meyer, Richard D Rames, Ryan M Nunley, Robert L Barrack
BACKGROUND: Cementless total knee arthroplasty (TKA) designs that incorporate a highly porous, titanium surface have the potential to achieve biologic fixation and improve component survivorship. This study's purpose was to compare perioperative and early postoperative outcomes of a cemented vs cementless TKA of the same design. METHODS: This was a retrospective review of a consecutive series of TKAs performed at a single institution using a cemented or cementless TKA of the same design (Triathlon, Stryker Inc, Mahwah, NJ)...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28217656/use-of-tranexamic-acid-in-total-knee-arthroplasty
#2
Francesco Marra, Federica Rosso, Matteo Bruzzone, Davide Edoardo Bonasia, Federico Dettoni, Roberto Rossi
PURPOSE: different strategies have been developed to reduce blood loss in total knee arthroplasty (TKA). The efficacy of both systemic and local tranexamic acid (TXA) administration is demonstrated in the literature. The aim of the present study was to compare the efficacy of systemic, local and combined (systemic + local) administration of TXA in reducing blood loss after TKA. METHODS: we enrolled all patients submitted to a primary TKA in our department between November 2014 and August 2015...
October 2016: Joints
https://www.readbyqxmd.com/read/28215968/unicompartmental-knee-arthroplasty-vs-total-knee-arthroplasty-for-medial-compartment-arthritis-in-patients-older-than-75-years-comparable-reoperation-revision-and-complication-rates
#3
Homayoun Siman, Atul F Kamath, Nazly Carrillo, William S Harmsen, Mark W Pagnano, Rafael J Sierra
BACKGROUND: Prior studies comparing unicompartmental knee arthroplasty (UKA) with total knee arthroplasty (TKA) in the elderly are limited by heterogeneity in arthritic disease patterns and patient selection. We report the results of UKA and TKA in patients 75 years and older with isolated medial compartmental arthritis, with special emphasis on immediate postoperative recovery, complications, reoperation rates, and implant survivorship at midterm follow-up. METHODS: A retrospective review was performed of all patients 75 years and older who underwent UKA or TKA at our institution between 2002 and 2012...
January 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28207503/clamping-drainage-is-unnecessary-after-minimally-invasive-total-knee-arthroplasty-in-patients-with-tranexamic-acid-a-randomized-controlled-trial
#4
Yuangang Wu, Timin Yang, Yi Zeng, Canfeng Li, Bin Shen, Fuxing Pei
BACKGROUND: Drainage and tranexamic acid (TXA) have been widely used in total knee arthroplasty (TKA). However, it remains unclear whether it is necessary to clamp the drain after minimally invasive TKA (MIS-TKA) when TXA is used. We therefore conducted a randomized controlled trial to compare the effects of clamping versus not clamping drainage following MIS-TKA in patients in whom TXA was used. METHODS: From January 2015 to December 2015, 121 patients undergoing unilateral primary MIS-TKA were enrolled and randomly divided into 2 groups...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28176599/the-combined-use-of-oral-and-topical-tranexamic-acid-is-a-safe-efficient-and-low-cost-method-in-reducing-blood-loss-and-transfusion-rates-in-total-knee-arthroplasty
#5
Deniz Cankaya, Uygar Dasar, Ahmet Burak Satilmis, Serdar Hakan Basaran, Mustafa Akkaya, Murat Bozkurt
AIMS: The combined (IV (intravenous) + topical) use of tranexamic acid (TXA) has been shown to be a safe method and more effective than single (IV or topical) application. The optimal administration method of TXA is still being investigated and safety, efficiency and cost are the three main crucial parameters in achieving the best administration method. We aimed to determine whether combined (oral + topical) use of TXA reduced blood loss and transfusion rates more than single (topical) administration in TKA and whether oral + topical use is as safe and efficient as the IV + topical use, in addition to the main advantage of relatively low cost...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28139973/effects-of-five-treatment-regimens-on-blood-loss-and-blood-transfusion-in-total-knee-arthroplasty-a-preliminary-study-in-china%C3%A2
#6
Kong-Zu Hu, He-Yan Sun, Cong Sui
OBJECTIVE: Our study is aimed to explore effects of five treatment regimens on blood loss and blood transfusion rate in total knee arthroplasty (TKA) patients. METHODS: 191 TKA patients were divided into the rivaroxaban, nadroparin, and tranexamic acid groups (n = 37 each) as well as into the affected-limb-position and tourniquet group (n = 40 each). A 3-month follow-up after operation was needed for all patients. The total blood loss, hidden blood loss, and dominant blood loss were recorded, and hemoglobin and red blood cell changes, pain and knee swelling degrees, hospital for special surgery (HSS), and American knee society (KSS) knee scores were observed...
January 30, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28103911/comparison-of-the-effectiveness-and-safety-of-topical-versus-intravenous-tranexamic-acid-in-primary-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#7
Tao-Ping Chen, Yu-Min Chen, Jian-Bao Jiao, Yun-Fei Wang, Li-Gang Qian, Zhao Guo, Zheng Ma, Cui-Yu Han, Tong-Huan Shi
BACKGROUND: This study aims to compare the effectiveness and safety of topical versus intravenous tranexamic acid (TXA) in reducing blood loss in primary total knee arthroplasty (TKA). METHODS: PubMed, Embase, the Cochrane Library, Web of Science, Chinese Biomedicine Literature (CBM), Wanfang Database and China National Knowledge Infrastructure (CNKI), and Google Scholar were searched for randomized controlled studies (RCTs) that compared topical versus intravenous TXA in terms of reducing blood loss during TKA from their inception to September 2015...
January 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28089184/bone-wax-is-effective-in-reducing-blood-loss-after-total-knee-arthroplasty
#8
Ing H Moo, Jerry Y Q Chen, Eric H Pagkaliwaga, See W Tan, Kein B Poon
BACKGROUND: Total knee arthroplasty (TKA) is associated with major blood loss and blood transfusion is often required. This study aimed to evaluate the efficacy of bone wax in reducing blood loss and transfusion rates after TKA. METHODS: A prospective randomized controlled study that included 100 patients undergoing primary unilateral TKA with cement was conducted in a tertiary center between March 2014 and June 2014. The bone wax group received 2.5 g of bone wax, applied onto the uncovered bone around the prostheses and the nail holes before the tourniquet was released, whereas the control group had hemostasis achieved using electrocautery only...
December 24, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28069329/chronic-kidney-disease-is-an-independent-risk-factor-for-transfusion-cardiovascular-complication-and-thirty-day-readmission-in-minimally-invasive-total-knee-arthroplasty
#9
Feng-Chih Kuo, Po-Chun Lin, Yu-Der Lu, Mel S Lee, Jun-Wen Wang
BACKGROUND: Little is known about the relationship between chronic kidney disease (CKD) and minimally invasive total knee arthroplasty (MIS-TKA). We hypothesized that CKD was an independent risk factor for postoperative complications and increased blood transfusion in patients following MIS-TKA. METHODS: A retrospective review of a prospective database was conducted on patients who underwent MIS-TKAs at an academic medical center between 2009 and 2012. Glomerular filtration rates (GFRs) were calculated for each patient at the time of surgery and a CKD group of 205 patients (GFR < 60 mL/min) were matched at a ratio of 1:2 with 410 patients showing a GFR ≥ 60 mL/min (control group)...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28032705/surgical-technique-of-total-knee-arthroplasty-without-soft-tissue-balance
#10
Hong-Tao Xu, Jiang-Tao Dong, Juan Wang, Shi-Jun Gao
Total knee arthroplasty (TKA) without soft tissue balance can create a balanced knee to a mechanical axis of near neutral with bone cuts, and remove osteophytes thoroughly. In this study, the authors present detailed steps for performing TKA. The attached video demonstrates the TKA procedure. The patient is a 77-year-old man who had suffered from knee pain for 12 years. Physical examination showed the Apley test to be positive and that the range of motion (ROM) decreased. An X-ray filmed at the positive lateral of the knee joint and the double lower extremity revealed a progression of degenerative osteoarthritis with genu varum...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28028616/impact-of-flexion-versus-extension-of-knee-position-on-outcomes-after-total-knee-arthroplasty-a-meta-analysis
#11
Chao Jiang, Jieqiong Lou, Wenwei Qian, Canhua Ye, Shibai Zhu
INTRODUCTION: Controversy still exists regarding positioning of the knee in flexion or in extension after total knee arthroplasty (TKA) impacts treatment outcomes. In this meta-analysis, we evaluated if a postoperative knee position regime could positively affect the rehabilitation. METHODS: A comprehensive search for randomized controlled trials (RCTs) assessing the effect of knee positioning after TKA was conducted. The outcomes of interest were blood loss and range of motion (ROM); total calculated blood loss (CBL), drainage volume, hidden blood loss (HBL), decline of hemoglobin level and requirement for blood transfusion...
February 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28026726/-intra-articular-application-of-tranexamic-acid-significantly-reduces-blood-loss-and-transfusion-requirement-in-primary-total-knee-arthroplasty
#12
J Lošťák, J Gallo, J Špička, K Langová
PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28005167/patient-specific-instrumentation-development-in-tka-1st-and-2nd-generation-designs-in-comparison-with-conventional-instrumentation
#13
Oh-Ryong Kwon, Kyoung-Tak Kang, Juhyun Son, Dong-Suk Suh, Dong Beom Heo, Yong-Gon Koh
INTRODUCTION: This study was conducted to determine if the difference in magnetic resonance imaging (MRI)-based 2nd generation patient-specific instrumentation (PSI) design affects post-operative restoration of neutral mechanical alignment in total knee arthroplasty (TKA) compared with the 1st generation PSI design and conventional surgical techniques. In addition, it is aimed at elucidating whether PSI improves surgical efficiency with respect to operating room time, estimated blood loss and the number of instrument trays used intra-operatively...
January 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28005108/comparing-cost-efficacy-and-safety-of-intravenous-and-topical-tranexamic-acid-in-total-hip-and-knee-arthroplasty
#14
COMPARATIVE STUDY
Joseph F DiBlasi, Ross P Smith, Jeffrey Garavaglia, Jeffrey Quedado, Benjamin M Frye, Matthew J Dietz
We conducted a study to compare the cost, efficacy, and safety of intravenous (IV) tranexamic acid (TXA) and topical TXA in primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). We retrospectively reviewed the cases of 291 patients who received either IV TXA or topical TXA before and after surgery. Significant differences favored topical TXA in reducing the postoperative decrease in hemoglobin levels in THA (P = .031) and TKA (P = .015) and calculated blood loss in TKA (P = .019). The groups did not differ in transfusion requirements for either THA or TKA...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28002321/is-combined-topical-with-intravenous-tranexamic-acid-superior-than-topical-intravenous-tranexamic-acid-alone-and-control-groups-for-blood-loss-controlling-after-total-knee-arthroplasty-a-meta-analysis
#15
REVIEW
Chunmei Lin, Yingmei Qi, Li Jie, Hong-Biao Li, Xi-Cheng Zhao, Lei Qin, Xin-Qiang Jiang, Zhen-Hua Zhang, Liping Ma
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy and safety of combined topical with intravenous tranexamic acid (TXA) versus topical, intravenous TXA alone or control for reducing blood loss after a total knee arthroplasty (TKA). METHODS: In May 2016, a systematic computer-based search was conducted in the PubMed, Embase, Cochrane Library, Web of Science, and Chinese Wanfang database...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27999958/use-of-patient-specific-cutting-blocks-reduces-blood-loss-after-total-knee-arthroplasty
#16
Vicente J León, María A Lengua, Víctor Calvo, Alonso J Lisón
Total knee arthroplasty (TKA) is associated with substantial blood loss. Sources of bleeding are the femoral and tibial intramedullary canals, which are violated during implantation using standard instrumentation. Patient-specific instrumentation (PSI) and computer-assisted surgery (CAS) do not require violation of the intramedullary canals. Therefore, we sought to assess the impact of these methods on blood loss and transfusion requirement. A retrospective cohort study was conducted in a series of 107 consecutive primary TKAs...
February 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27999500/benefits-of-limited-use-of-a-tourniquet-combined-with-intravenous-tranexamic-acid-during-total-knee-arthroplasty
#17
Alexander D Rosenstein, Yehuda A Michelov, Stephanie Thompson, Alan D Kaye
BACKGROUND: Blood loss during total knee arthroplasty (TKA) may require blood transfusions that are associated with increased risk, morbidity, and cost. Multiple techniques exist to reduce blood loss in TKA, including the use of a tourniquet and tranexamic acid (TXA). While multiple studies suggest that TXA is effective in reducing blood loss, the use of a tourniquet is more controversial. We studied the combined effect of TXA with a limited-use tourniquet on blood loss and complications in the setting of primary TKA...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27995304/patient-specific-instrumentation-versus-conventional-knee-arthroplasty-comparative-study
#18
Vlad Predescu, Catalin Prescura, Razvan Olaru, Liliana Savin, Paul Botez, Bogdan Deleanu
BACKGROUND: The key to a successful knee replacement is restoring normal kinematics with a neutral alignment, thus a hip-knee-ankle (HKA) angle of 180° (within 3° limits). Conventional TKR is proven to have excellent results but relies in extensive visual referencing of bony landmarks. Customised cutting blocks provide accurate bone cuts, also lowering the risk of fat embolism, blood loss and operating time. METHOD: We share our experience comparing two different TKA techniques using patient specific instrumentation (PSI) with the Visionaire knee and conventional instrumentation (CVI) from the same system (Genesis II Smith&Nephew)...
December 19, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27984847/intraarticular-administration-of-tranexamic-acid-is-safe-and-effective-in-total-knee-arthroplasty-patients-at-high-risk-for-thromboembolism
#19
Ronald E Delanois, Chukwuweike Gwam, Jaydev B Mistry, Morad Chughtai, Melbin Thomas, Prathik P Mudaliar, Anton Khlopas, Vidur Tangri, Michael A Mont
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent that can be used to reduce blood loss in total knee arthroplasty (TKA) patients. Due to its thrombogenic properties, intravenous (IV) TXA is contraindicated in patients who have an increased risk of arterial or venous thrombosis. For such patients, intraarticular (IA) TXA may be a safe alternative. In this study, we compare: 1) complication rates; 2) intraoperative blood loss; and 3) need for transfusion in TKA patients who received IA TXA versus patients who used IV TXA...
December 16, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27977593/comparing-efficacy-and-safety-of-2-methods-of-tranexamic-acid-administration-in-reducing-blood-loss-following-total-knee-arthroplasty-a-meta-analysis
#20
COMPARATIVE STUDY
Yu Fu, Zhigang Shi, Bing Han, Yong Ye, Tao You, Juehua Jing, Jun Li
BACKGROUND: The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) were to gather data to evaluate the efficacy and safety of topical tranexamic acid (TXA) versus intravenous (IV) TXA for blood loss after a total knee arthroplasty (TKA). METHODS: Electronic databases: Pubmed, Web of Science, Cochrane library, and Embase from inception to June 2016 were searched. RCTs that comparing topical with IV TXA for blood loss control in patients prepared for TKA were included in this meta-analysis...
December 2016: Medicine (Baltimore)
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