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TKA AND blood loss

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https://www.readbyqxmd.com/read/29137681/influence-of-tourniquet-use-in-primary-total-knee-arthroplasty-with-drainage-a-prospective-randomised-controlled-trial
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28939033/epsilon-aminocaproic-acid-to-reduce-blood-loss-and-transfusion-after-total-hip-and-total-knee-arthroplasty
#11
Juliann C Hobbs, Ian J Welsby, Cynthia L Green, Ishwori B Dhakal, Samuel S Wellman
BACKGROUND: Total hip and knee arthroplasty (THA and TKA) are associated with significant blood loss and some patients require postoperative blood transfusion. While tranexamic acid has been studied extensively among this population, we tested the hypothesis that epsilon aminocaproic acid (EACA) can reduce blood loss and transfusion after joint arthroplasty. METHODS: In April 2014, our Veterans Affairs Medical Center introduced a protocol to administer EACA during THA and TKA...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28927562/periarticular-injection-of-tranexamic-acid-reduces-blood-loss-and-the-necessity-for-allogeneic-transfusion-after-total-knee-arthroplasty-using-autologous-transfusion-a-retrospective-observational-study
#12
Sain Yozawa, Hiroyasu Ogawa, Kazu Matsumoto, Haruhiko Akiyama
BACKGROUND: This study aimed to examine the influence of a periarticular injection of tranexamic acid (TXA) on blood loss after a total knee arthroplasty (TKA) in patients who received an autologous blood transfusion. METHODS: We retrospectively reviewed the medical charts of 82 patients (88 consecutive knees) who underwent a primary unilateral TKA with or without a periarticular TXA injection (TXA and control groups, respectively). All patients underwent an autologous blood transfusion...
August 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28922709/non-drainage-versus-drainage-in-tourniquet-free-knee-arthroplasty-a-prospective-trial
#13
Kai Zhou, Haoyang Wang, Jinglong Li, Duan Wang, Zongke Zhou, Fuxing Pei
BACKGROUND: It is still unknown whether drainage is necessary and non-drainage is safe and acceptable after tourniquet-free total knee arthroplasty (TKA). We aim to investigate whether non-drainage use is accepted in TKA that is performed without a tourniquet. METHODS: Clinical data of 80 adult patients who did or did not receive drainage in our centres from August 2015 to December 2015 were prospective investigated. RESULTS: The drainage group exhibited reduced hidden blood loss (47...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28899856/release-of-the-tourniquet-immediately-after-the-implantation-of-the-components-reduces-the-incidence-of-deep-vein-thrombosis-after-primary-total-knee-arthroplasty
#14
P Zan, M O Mol, J J Yao, L Fan, D Yang, K Liu, G Li
AIMS: The length of the tourniquet time during total knee arthroplasty (TKA) is related to the incidence of post-operative deep vein thrombosis (DVT). Our aim in this study was to investigate the effect of the early release of the tourniquet on the incidence of DVT in patients undergoing TKA. METHODS: A total of 200 patients who underwent TKA between November 2015 and November 2016 were prospectively enrolled. The tourniquet was inflated before surgery and released immediately after the introduction of the components (early release group)...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28867520/comparison-of-the-iassist-handheld-guidance-system-to-conventional-instruments-for-mechanical-axis-restoration-in-total-knee-arthroplasty
#15
Matthew C Kinney, Krishna R Cidambi, Dustyn L Severns, Francis B Gonzales
BACKGROUND: Recent advances in total knee arthroplasty (TKA) include an intelligent instrument system designed to provide intraoperative guidance to reduce mechanical alignment errors. Internal position-sensing technology is integrated into microelectronic pods that attach to cutting blocks. The purpose of this prospective, randomized study was to determine whether this iAssist system enables the surgeon to make more accurate bone resections and better restore the mechanical axis compared to conventional instruments in TKA...
June 9, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28865444/application-of-postoperative-autotransfusion-in-total-joint-arthroplasty-reduces-allogeneic-blood-requirements-a-meta-analysis-of-randomized-controlled-trials
#16
Weiping Ji, Xianfeng Lin, Ruoxia Zhang, Pan Tang, Jian Mo, Xinyi Teng, Qiuping Fan, Bo Wang, Shunwu Fan, Jianfeng Zhang, Shuai Chen, Kangmao Huang
BACKGROUND: Total joint arthroplasty is associated with significant blood loss and often requires blood transfusion. However, allogeneic blood transfusion (ABT) may lead to severe problems, such as immunoreaction and infection. Postoperative autotransfusion, an alternative to ABT, is controversial. We conducted a meta-analysis to evaluate the ability of postoperative autotransfusion to reduce the need for ABT following total knee arthroplasty (TKA) and total hip arthroplasty (THA). METHODS: Systematic literature searches for randomized controlled trials were performed using PubMed, Embase, and the Cochrane Library until February 2016...
September 2, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28844765/extremely-low-transfusion-rates-contemporary-primary-total-hip-and-knee-arthroplasties
#17
Ida S Lindman, Lars V Carlsson
BACKGROUND: Considerable blood loss which requires transfusion is frequently reported after total hip and knee arthroplasties (THA and TKA). The purpose of this study is to review the transfusion rates in contemporary THA and TKA with optimized perioperative protocols including minimized surgical trauma and optimal perioperative patient care. METHODS: This retrospective study included 1442 consecutive patients receiving either a primary THA or a TKA from the same high-volume surgeon between January 2008 and December 2015...
July 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28827053/bilateral-simultaneous-unicompartmental-knee-arthroplasty-versus-unilateral-total-knee-arthroplasty-a-comparison-of-the-amount-of-blood-loss-and-transfusion-perioperative-complications-hospital-stay-and-functional-recovery
#18
J H Ahn, D M Kang, K J Choi
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is a good alternative treatment option to total knee arthroplasty (TKA) for single compartment knee osteoarthritis. Several recent reports suggest that UKA results in more rapid functional recovery than TKA, together with fewer complications. Few performed a comparison of bilateral simultaneous UKA and unilateral TKA. HYPOTHESIS: Bilateral simultaneous UKA would result in fewer perioperative complications, less blood loss, less transfusion and faster recovery of short-term clinical outcomes, compared with unilateral TKA patients...
August 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28792707/limitations-of-preoperative-pfa-200-as-a-predictor-of-postoperative-blood-loss-in-total-knee-arthroplasty-according-to-use-of-tranexamic-acid
#19
You La Jeon, Woo-In Lee, So Young Kang, Myeong Hee Kim
BACKGROUND: Recently, anti-fibrinolytic agents (tranexamic acid) have been used to reduce blood loss or and the need for transfusion. We evaluated the clinical utility of PFA-200 as a predictor of postoperative blood loss in a clinical setting, where hemostasis can be affected by variables such as existing comorbidities and medication use. METHODS: We analyzed retrospectively 243 TKA patients having PFA-200 results between March 2014 and May 2016. We collected the medication history of anti-thrombotic agents, closure time measured by PFA-200, postoperative drainage volume, and perioperative change of hemoglobin values...
July 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28768781/usefulness-of-an-accelerometer-based-portable-navigation-system-in-total-knee-arthroplasty
#20
RANDOMIZED CONTROLLED TRIAL
T Ikawa, S Takemura, M Kim, K Takaoka, Y Minoda, Y Kadoya
AIMS: The aim of this study was to evaluate the effects of using a portable, accelerometer-based surgical navigation system (KneeAlign2) in total knee arthroplasty (TKA) on the alignment of the femoral component, and blood loss. PATIENTS AND METHODS: A total of 241 consecutive patients with primary osteoarthritis of the knee were enrolled in this prospective, randomised controlled study. There were 207 women and 34 men. The mean age of the patients was 74.0 years (57 to 89)...
August 2017: Bone & Joint Journal
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