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TKA AND blood loss

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https://www.readbyqxmd.com/read/29758073/effects-of-computer-assisted-navigation-versus-conventional-total-knee-arthroplasty-on-the-levels-of-inflammation-markers-a-prospective-study
#1
Shu-Jui Kuo, Horng-Chaung Hsu, Ching-Jen Wang, Ka-Kit Siu, Ya-Hung Hsu, Jih-Yang Ko, Chih-Hsin Tang
Total knee arthroplasty (TKA) is a well-established modality for the treatment of advanced knee osteoarthritis (OA). However, the detrimental effects of intramedullary reaming used in conventional TKA for distal femur cutting are of concern. Avoiding intramedullary reaming with the use of computer-assisted navigation TKA can not only provide superior prosthetic alignment, but also mitigate perioperative blood loss and the dissipation of marrow emboli. We quantified local and systemic concentrations of inflammation markers for both techniques...
2018: PloS One
https://www.readbyqxmd.com/read/29733996/low-molecular-weight-heparin-for-the-prevention-of-deep-venous-thrombosis-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#2
REVIEW
Ze-Nan Xia, Qing Zhou, Wei Zhu, Xi-Sheng Weng
BACKGROUND: To systematically evaluate the prophylaxis efficacy of low-molecular-weight heparin (LMWH) in the prevention of deep venous thrombosis (DVT) after total knee arthroplasty (TKA). METHOD: PubMed, Cochrane, Embase, Wanfang, CNKI, and VIP databases were searched by index words to identify the eligible RCTs; relevant literature sources were also searched. The latest research was conducted in March 2017. Relative risks (RR), mean difference (MD), and their corresponding 95% confidence intervals (95% CIs) were used to analyze the main outcomes...
May 4, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29731267/prior-anterior-cruciate-ligament-reconstruction-effects-on-future-total-knee-arthroplasty
#3
Alexander C M Chong, Brandon T Fisher, Lisa N MacFadden, Bruce E Piatt
BACKGROUND: The impact of prior anterior cruciate ligament (ACL) reconstruction on total knee arthroplasty (TKA) has rarely been studied. The objective of this study was to compare intraoperative characteristics in patients who underwent TKA with pre-existing hardware from prior ACL reconstruction with a matched cohort control group. METHODS: A retrospective study of patients who had undergone primary TKA with pre-existing hardware from prior ACL reconstruction was performed from June 2012 through June 2017...
April 19, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29727870/minimizing-blood-loss-and-transfusions-in-total-knee-arthroplasty
#4
Charles Cody White, Josef K Eichinger, Richard J Friedman
Blood loss management is critical to positive outcomes in patients undergoing total knee arthroplasty (TKA). Transfusions are associated with an increased risk of major and minor adverse events, length of hospitalization, and overall cost associated with surgery. Many techniques have been investigated and compared. Tranexamic acid (TXA), an antifibrinolytic drug widely known to reduce blood loss, may be a bridge to the goal of eliminating blood transfusions from TKA. Administration of TXA can be performed intravenously, topically at the knee joint, orally, or in combination...
May 4, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29718858/efficacy-and-safety-of-oral-tranexamic-acid-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#5
Peipei Guo, Zike He, Yanhua Wang, Fuqiang Gao, Wei Sun, Wanshou Guo, Zirong Li, Liming Cheng
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic drug widely used as a blood-sparing technique in total knee arthroplasty (TKA), and it is usually administrated by intravenous or intraarticular injection. Recently, the oral form of TXA has been applied in TKA patients. However, there is no final consensus regarding the effectiveness and safety of oral TXA. The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the efficacy and safety of oral TXA versus control for blood loss after TKA...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29695912/tranexamic-acid-reduces-intraoperative-occult-blood-loss-and-tourniquet-time-in-obese-knee-osteoarthritis-patients-undergoing-total-knee-arthroplasty-a-prospective-cohort-study
#6
Yutong Meng, Zhirui Li, Ke Gong, Xiao An, Jiyuan Dong, Peifu Tang
Purpose: Obesity can result in increased blood loss, which is correlated with poor prognosis in total knee arthroplasty (TKA). Clinical application of tranexamic acid is effective in reducing blood loss in TKA. However, most previous studies focused on the effect of tranexamic acid in the whole population, neglecting patients with specific health conditions, such as obesity. We hypothesized that tranexamic acid would reduce blood loss to a greater extent in obese patients than in those of normal weight...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29693237/intravenous-tranexamic-acid-only-versus-combined-intravenous-and-intra-articular-tranexamic-acid-for-perioperative-blood-loss-in-patients-undergoing-total-knee-arthroplasty
#7
Takuya Iseki, Sachiyuki Tsukada, Motohiro Wakui, Shinichi Yoshiya
PURPOSE: This study was performed to assess the effectiveness of the combined intravenous and intra-articular tranexamic acid (TXA) regimen in total knee arthroplasty (TKA). METHODS: The perioperative blood loss in 75 consecutive patients undergoing unilateral TKA that received both 1000 mg of TXA intravenously and 1000 mg of intra-articular TXA (combined TXA group) was compared with a consecutive series of 77 patients that received 1000 mg of TXA intravenously (intravenous TXA group)...
April 24, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29665835/the-efficacy-of-intravenous-aminocaproic-acid-in-primary-total-hip-and-knee-arthroplasty-a-meta-analysis
#8
Yong-Jiang Li, Bi-Sheng Xu, Sun-Peng Bai, Xiao-Jun Guo, Xiang-Yuan Yan
BACKGROUND: We conducted a meta-analysis from randomized controlled trials (RCTs) and non-RCTs to assess the efficacy of aminocaproic acid in cases of primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: Potentially relevant academic articles were identified from the Cochrane Library, MEDLINE (1966-2017 October 31), PubMed (1966-2017 October 31), EMBASE (1980-2017 October 31), and ScienceDirect (1985-2017 October 31). Secondary sources were identified from the references of the included literature...
April 17, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29656129/no-difference-in-implant-survivorship-and-clinical-outcomes-between-full-cementless-and-full-cemented-fixation-in-primary-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#9
REVIEW
Kai Zhou, Haoda Yu, Jinglong Li, Haoyang Wang, Zongke Zhou, Fuxing Pei
BACKGROUND: The debate over the use of cemented or cementless fixation in total knee arthroplasty (TKA) has never stopped since cementless fixation was introduced. We undertook a systematic review and meta-analysis to evaluate the optimal mode of fixation (full-cementless vs. full-cemented) in TKA. METHODS: PubMed, Embase, and the Cochrane Library databases up to July 2017 were searched to identify randomised controlled trials (RCTs) and quasi-RCTs comparing full-cementless TKA and full-cemented TKA...
April 12, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29628683/short-term-outcomes-of-long-duration-versus-short-duration-tourniquet-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#10
Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay, Manish Kumar Tiwari
Introduction: A tourniquet is used during the total knee replacement surgery to improve the visibility, to reduce the blood loss and for better cementation. Indirectly it decreases the duration of surgery and enhances the recovery of the patient. Their use however is controversial due to some side effects associated with the use of tourniquet. They may increase the risk of deep vein thrombosis and pulmonary embolism by causing venous stasis, endothelial damage and increased platelet adhesion secondary to distal limb ischemia...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29578494/patient-specific-instruments-routine-use-over-conventional-total-knee-arthroplasty-remains-inconclusive-analysis-of-961-cases
#11
Antonio Klasan, Philipp Dworschak, Thomas J Heyse, Matthias Lahner, Dominik Malcherczyk, Turgay Efe, Bilal Farouk El-Zayat
BACKGROUND: An increasing demand for total knee arthroplasty (TKA) has pushed innovations in the industry and created a promising new technique called patient specific instruments (PSI). Early reports had promising results such as reducing operative time, cost, and improved alignment. More recent reports are conflicting. OBJECTIVE: We aimed to evaluate bleeding, operative time, complication rates, and in-hospital stay. METHODS: A monocentric retrospective analysis was performed on a total of 961 patients that met inclusion criteria...
March 16, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29576638/is-combined-administration-of-tranexamic-acid-better-than-both-intravenous-and-topical-regimes-for-total-loss-hidden-loss-and-post-operative-swelling-a-randomized-control-trial
#12
Jatin Prakash, Jong-Keun Seon, Eun-Kyoo Song, Dong-Hyun Lee, Hong-Yeol Yang, Cheng Jin
Background: Bleeding is one of the unavoidable complications of total knee arthroplasty (TKA). Tranexamic acid (TXA) in last decade has emerged as an effective and safe way to decrease postoperative bleeding and transfusion rates. Although there is little doubt on the efficacy of the drug, the debate on ideal mode is more recent. We undertook this study to find out the most effective and yet safest way of TXA administration. Materials and Methods: A single institution - two hospital-based, double-blinded, prospective, randomized control trial was conducted from January 2015 to December 2015...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29560402/continuing-versus-discontinuing-antiplatelet-drugs-vasodilators-and-or-cerebral-ameliorators-on-perioperative-total-blood-loss-in-total-knee-arthroplasty-without-pneumatic-tourniquet
#13
Sachiyuki Tsukada, Motohiro Wakui
Background: Although studies have supported the utility of perioperative continuation of antiplatelet drugs, vasodilators, and cerebral ameliorators in most procedures, no study compared total volume of blood loss after total knee arthroplasty (TKA) in patients continuing and discontinuing these drugs. Methods: We retrospectively reviewed 266 consecutive patients undergoing TKA, and included 67 patients (25.2%) taking antiplatelet drugs, vasodilators, or cerebral ameliorators in this study...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29560401/a-prospective-randomized-comparative-study-of-intravenous-alone-and-combined-intravenous-and-intraarticular-administration-of-tranexamic-acid-in-primary-total-knee-replacement
#14
Paolo Adravanti, Eleonora Di Salvo, Giuseppe Calafiore, Sebastiano Vasta, Aldo Ampollini, Michele Attilio Rosa
Background: Studies on the use of tranexamic acid (TXA) to improve clinical outcomes after joint arthroplasty have reported contrasting results between intravenous (IV) TXA alone and combined IV and intraarticular (IA) administration. We compared the effectiveness of the 2 methods in providing higher postoperative hemoglobin (Hb) levels in patients undergoing primary total knee arthroplasty (TKA). Methods: A total of 100 TKA patients were randomly assigned to receive either IV TXA alone (group 1) or combined IV and topical IA TXA (group 2)...
March 2018: Arthroplasty Today
https://www.readbyqxmd.com/read/29544472/comparison-of-oral-versus-intra-articular-tranexamic-acid-in-enhanced-recovery-primary-total-knee-arthroplasty-without-tourniquet-application-a-randomized-controlled-trial
#15
Duan Wang, Hui Zhu, Wei-Kun Meng, Hao-Yang Wang, Ze-Yu Luo, Fu-Xing Pei, Qi Li, Zong-Ke Zhou
BACKGROUND: Although randomized controlled trials have confirmed oral tranexamic acid (TXA) can provide similar blood-sparing efficacy compared with intravenous (IV) TXA in total knee arthroplasty (TKA), some concerns do remain about thromboembolic events after such systemic administration. Many studies have confirmed that intra-articular (IA) application of TXA can show similar blood-saving efficacy with minimal levels of systemic absorption compared with IV TXA. However, it remains unclear whether the efficacy and safety of oral TXA administration is equal to or less than that of IA administration in TKA without the use of a tourniquet and drain...
March 15, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29530063/the-efficacy-of-synovectomy-for-total-knee-arthroplasty-a-meta-analysis
#16
Zi-Qin Zhao, Jin Xu, Rui-Lin Wang, Li-Na Xu
BACKGROUND: Many studies have proposed synovectomy during total knee arthroplasty (TKA) to reduce pain after TKA. The aim of this study was to assess the outcomes of synovectomy for treating of TKA through a meta-analysis. METHODS: Relevant clinical studies on synovectomy and without synovectomy were retrieved through searching the databases PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to January 2018. Studies that investigated the comparison of pain scores, total blood loss, range of motion, functional Knee Society Scores (KSSs), clinical KSSs, and operating time and provided sufficient data of interest were included in this meta-analysis...
March 12, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29521284/additional-dose-of-intravenous-tranexamic-acid-after-primary-total-knee-arthroplasty-further-reduces-hidden-blood-loss
#17
Zi-Jian Li, Min-Wei Zhao, Lin Zeng
Background: Total knee arthroplasty (TKA) is the most frequently performed procedure in treating advanced knee osteoarthritis. Excessive perioperative blood loss can sometimes lead to postoperative anemia. Tranexamic acid (TXA) is a potent fibrinolysis inhibitor which has been extensively used at the surgical incision and closure to lower overall blood loss in adult reconstruction surgery. Our previous study suggested that about two-thirds of the total blood loss (TBL) came from hidden blood loss (HBL) on postoperative days 1 and 2...
March 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29510953/comparing-the-effect-of-tourniquet-vs-tourniquet-less-in-simultaneous-bilateral-total-knee-arthroplasties
#18
Mohamed Shaher Hasanain, Dragos Apostu, Attaallh Alrefaee, Samih Tarabichi
BACKGROUND: Total knee arthroplasty (TKA) is a commonly performed procedure worldwide for the treatment of knee joint disease. Tourniquet is frequently used during the entire procedure to reduce blood loss and increase surgical comfort. On the other hand, tourniquet-related complications exist, and there are still controversies whether benefits outweigh the risks. METHODS: Patients undergoing simultaneous TKAs had one knee assigned to group A (use of tourniquet during the entire procedure) and the other knee assigned to group B (use of tourniquet only during cementation)...
February 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29505518/effectiveness-and-safety-of-an-optimized-blood-management-program-in-total-hip-and-knee-arthroplasty-a-large-single-center-retrospective-study
#19
Shaoyun Zhang, Qiang Huang, Bin Xu, Jun Ma, Guorui Cao, Fuxing Pei
Little has been published on blood management in total hip and knee arthroplasty (THA and TKA, respectively) patients focusing on both hematopoiesis and hemostasis. Our aim was to explore the effectiveness and safety of an optimized blood management program in THA and TKA patients in a large, single-center, retrospective study.We retrospectively reviewed consecutive primary unilateral THA and TKA patients' data at our institution through the National Health Database. They were divided into 3 groups according to an optimized blood management program: group A-combined use of intravenous and topical tranexamic acid (TXA); group B-use of recombinant human erythropoietin (rHuEPO) and iron supplements in addition to treatments in group A; group C-use of additional multiple boluses of TXA in addition to treatments in group B...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29495221/-effectiveness-evaluation-between-enhanced-recovery-after-surgery-and-traditional-treatment-in-unilateral-total-knee-arthroplasty
#20
D Zhao, X L Ma, W L Wang, L Zhang
Objective: To investigate the clinical effect of enhanced recovery after surgery (ERAS) in unilateral total knee arthroplasty (TKA). Methods: Retrospective analysis of 98 patients received unilateral TKA from September 2015 to September 2016 in the Orthopaedic Departmentof Affiliated Hospital of Logistics University of Chinese People's Armed Police Forces.Of the patients, 52 cases were treated by traditional operation (routine group) and the other 46 cases were treated with ERAS concept (ERAS group). The following data were gathered and statistically analyzed between the groups: gender, age, body mass index, preoperative hemoglobin, preoperative visual analogue scale (VAS) score, postoperative visible blood loss, postoperative hemoglobin at 24 hour after operation, blood transfusion rate, postoperative VAS score, length of hospital stay, the satisfaction rate, preoperative and 1 and 6 months postoperative evaluation with hospital for special surgery knee score (HSS), postoperative range of motion (ROM) of knees after 2 weeks, 1 month and 6 months of surgery, incidence rate of complications after surgery...
February 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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