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TKA AND blood salvage

Hitoshi Imamura, Shigeki Momohara, Koichiro Yano, Yu Sakuma, Masanori Nakayama, Haruki Tobimatsu, Katsunori Ikari
OBJECTIVE: Since IL-6 has been associated with activation of the coagulation cascade and upregulation of fibrinogen transcription, we retrospectively tested the hypothesis that patients with rheumatoid arthritis (RA) treated with tocilizumab (TCZ) may lose more blood when undergoing total knee arthroplasty (TKA). METHODS: This study included 115 RA patients who underwent primary TKA and were preoperatively tested for fibrinogen levels. The blood volume of each patient was calculated using the Nadler formula, and estimated blood loss after TKA was calculated as the change between pre-operative and post-operative hematocrits...
January 30, 2018: Modern Rheumatology
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
Kun-Hao Hong, Jian-Ke Pan, Wei-Yi Yang, Ming-Hui Luo, Shu-Chai Xu, Jun Liu
BACKGROUND: Autologous blood transfusion (ABT) drainage system is a new unwashed salvaged blood retransfusion system for total knee replacement (TKA). However, whether to use ABT drainage, closed-suction (CS) drainage or no drainage in TKA surgery remains controversial. This is the first meta-analysis to assess the clinical efficiency, safety and potential advantages regarding the use of ABT drains compared with closed-suction/no drainage. METHODS: PubMed, Embase, and the Cochrane Library were comprehensively searched in March 2015...
August 1, 2016: BMC Musculoskeletal Disorders
Massimiliano Leigheb, Francesco Pogliacomi, Michela Bosetti, Francesca Boccafoschi, Maurizio Sabbatini, Mario Cannas, Federico Grassi
BACKGROUND AND AIM OF THE WORK: We aimed to compare Postoperative Blood Salvage (PBS) with Allogeneic Blood Transfusion (ABT) in patients undergoing Total Hip and Knee Arthroplasty (THA, TKA).  METHODS: A bibliographic research was carried out in order to review the literature dedicated to postoperative blood salvage in major orthopaedic surgery, excluding papers dealing exclusively with preoperative autologous donation, intraoperative blood salvage and ABT. PBS and ABT were compared according to complications, costs and duration of hospitalization...
April 15, 2016: Acta Bio-medica: Atenei Parmensis
M M Tió, G Sánchez-Etayo, R Bergé, F Salazar, M Basora, X Sala-Blanch
OBJECTIVES: Total knee arthroplasty (TKA) has a high transfusion rate. In our protocol, the use of postoperative cell salvage is indicated in patients with contraindications to tranexamic acid (TA). An analysis was performed on the effect of post-operative cell salvage (POCS) regarding transfusion rate and costs in patients undergoing TKA. MATERIAL AND METHODS: A prospective analysis was conducted on 518 patients, of whom 434 received TA, and 84 were contraindicated...
October 2016: Revista Española de Anestesiología y Reanimación
Tyler Barker, Victoria E Rogers, Vanessa T Henriksen, Kimberly B Brown, Roy H Trawick, Nathan G Momberger, G Lynn Rasmussen
BACKGROUND: This study aimed to identify (1) if the postoperative increase in the neutrophil-to-lymphocyte ratio (NLR) is different between contrasting knee arthroplasty procedures, and (2) if the NLR predicts venous thromboembolism (VTE) after total knee arthroplasty (TKA). MATERIALS AND METHODS: To address the first objective, we retrospectively studied patients who underwent primary unilateral TKA (n = 111) or unicompartmental knee arthroplasty (UKA; n = 74) between 2009 and 2012...
June 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Leti van Bodegom-Vos, Veronique M Voorn, Cynthia So-Osman, Thea P Vliet Vlieland, Albert Dahan, Ankie W Koopman-van Gemert, Stephan B Vehmeijer, Rob G Nelissen, Perla J Marang-van de Mheen
BACKGROUND: Cell salvage is used to reduce allogeneic red blood-cell (RBC) transfusions in total hip arthroplasty (THA) and total knee arthroplasty (TKA). We performed a meta-analysis to assess the effectiveness of cell salvage to reduce transfusions in THA and TKA separately, and to examine whether recent trials change the conclusions from previous meta-analyses. METHODS: We searched MEDLINE through January 2013 for randomized clinical trials evaluating the effects of cell salvage in THA and TKA...
June 17, 2015: Journal of Bone and Joint Surgery. American Volume
James B Benjamin, Kimen M Colgan
A sequential series of 366 primary total knee arthroplasties and 320 total hip arthroplasties was reviewed to determine the incidence of allogeneic transfusion. Surgery was performed under regional anesthesia and all patients had a hemovac drain for 24°. Tourniquet hemostasis in TKA was maintained through wound closure. Coumadin, SCD and TED hose were utilized for DVT prophylaxis. No additional blood conservation measures were employed. The transfusion incidence in primary TKA was 2.2% (males .6%/females 3...
June 2015: Journal of Arthroplasty
Samik Banerjee, Bhaveen H Kapadia, Kimona Issa, Mark J McElroy, Harpal S Khanuja, Steven F Harwin, Michael A Mont
Blood loss is a serious concern during lower extremity total joint arthroplasty with the estimated reduction in hemoglobin concentration known to vary between 2 and 4 g/dL after total knee arthroplasty (TKA). Allogeneic transfusions are commonly used to treat the acute blood loss and postoperative anemia to diminish the potential cardiovascular risks in up to 50% of such cases with a high volume of blood loss. However, these transfusions are associated with the risks of immunologic reactions, immunosuppression, and infection transmission...
December 2013: Journal of Knee Surgery
Samik Banerjee, Kimona Issa, Bhaveen H Kapadia, Harpal S Khanuja, Steven F Harwin, Vincent K McInerney, Michael A Mont
Substantial amounts of perioperative blood loss occur during total knee arthroplasty (TKA) that may require allogeneic transfusion in more than 30% of patients. Increased blood loss leads to poor physical functioning, increases infection risks, and prolongs hospitalization, which may eventually affect the overall clinical outcomes of TKA. In addition, allogeneic blood transfusions are associated with increased risks of transfusion reactions, immunosuppression, and a variety of immunological reactions. These concerns have led surgeons and anesthesiologists to develop various strategies to conserve blood, reduce costs, and decrease complications related to blood transfusions...
December 2013: Journal of Knee Surgery
D G Kang, S Khurana, J H Baek, Y S Park, S H Lee, K I Kim
The purpose of this study was to evaluate the efficacy and safety of postoperative wound drain salvage and autotransfusion system in haemophilic patients undergoing elective total knee arthroplasty (TKA). No literature exists on reinfusing drained blood in patient with haemophilia undergoing TKA. Eighty-eight knees of 66 patients received cemented TKA due to end-stage haemophilic arthropathy (group I; with autotransfusion in 59 knees, group II; without autotransfusion in 29 knees). In group I, the postoperative shed blood was transfused within 6 h after surgery...
January 2014: Haemophilia: the Official Journal of the World Federation of Hemophilia
Kresimir Oremus, Sinisa Sostaric, Vladimir Trkulja, Miroslav Haspl
BACKGROUND: Postoperatively shed blood salvage is commonly used to reduce allogenic blood transfusion in patients undergoing total hip (THA) and knee arthroplasty (TKA). Autologous blood retransfusion is not devoid of risk. We hypothesized that adding tranexamic acid (TXA) to a restrictive blood transfusion protocol would reduce the need for postoperative autologous blood retransfusion in primary knee and hip arthroplasty. STUDY DESIGN AND METHODS: Ninety-eight adult patients undergoing primary THA or TKA were randomly assigned to receive an intraoperative intravenous loading dose of 1...
January 2014: Transfusion
Johannes Cip, Mark Widemschek, Thomas Benesch, Roman Waibel, Arno Martin
BACKGROUND: Mechanical autotransfusion systems for washed shed blood (WSB) were introduced to reduce the need for postoperative allogenic blood transfusions (ABTs). Although some authors have postulated decreased requirements for ABT by using autologous retransfusion devices, other trials, mostly evaluating retransfusion devices for unwashed shed blood (USB), verified a small or no benefit in reducing the need for postoperative ABT. Because of these contradictory findings it is still unclear whether autologous retransfusion systems for WSB can reduce transfusion requirements...
April 2013: Clinical Orthopaedics and related Research
Bartłomiej Dobosz, Julian Dutka, Lukasz Dutka, Paweł Maleta
BACKGROUND: An increasing demand for blood products forces the rationalisation of management and conservation of blood. The aim of the study is to evaluate the possibility of retransfusion of blood conservation and the cost-effectiveness of this procedure when employed in Total Hip Replacement and Total Knee Arthroplasty. MATERIAL AND METHODS: This prospective cohort study involved two groups of patients. Group I comprised 50 patients who underwent blood retransfusion and in several cases had supplementary allogeneic transfusion...
September 2012: Ortopedia, Traumatologia, Rehabilitacja
B Kučera, D Náhlík, R Hart, L Oceláková
PURPOSE OF THE STUDY: The aim of the study was to compare the effect of post-operative retransfusion with that of intra-operative autotransfusion in non-anaemic patients undergoing total knee arthroplasty (TKA). MATERIAL AND METHODS: Between February 2004 and June 2006, a total of 129 patients free of anaemia who underwent elective primary unilateral cemented TKA for primary arthritis received blood retransfusion by means of the post-operative retransfusion system...
2012: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Gerhardt Konig, Mark H Yazer, Jonathan H Waters
BACKGROUND: There is concern that salvaged blood has the potential to activate the coagulation system, which might place patients at risk of thrombotic complications. The aim of this study was to determine whether transfusion of salvaged blood after total knee arthroplasty (TKA) would lead to procoagulopathic changes as measured by thromboelastography (TEG) and furthermore if washing would reduce this risk. STUDY DESIGN AND METHODS: Twenty-two patients undergoing TKA were enrolled...
June 2013: Transfusion
Vidya K Rao, Robert Dyga, Christopher Bartels, Jonathan H Waters
BACKGROUND: The increasing costs, limited supply, and clinical risks associated with allogeneic blood transfusion have prompted investigation into autologous blood management strategies, such as postoperative red blood cell (RBC) salvage. This study provides a cost comparison of transfusing washed postoperatively salvaged RBCs using an orthopedic perioperative autotransfusion device (OrthoPat, Haemonetics Corporation) versus unwashed shed blood and banked allogeneic blood. STUDY DESIGN AND METHODS: Cell salvage data were retrospectively reviewed for a sample of 392 patients who underwent primary hip or knee arthroplasty...
August 2012: Transfusion
Clifford Kent Boese, Theresa J Gallo, Marcia Weis, Rebecca Baker, Carla J Plantikow, Brian Cooley
We retrospectively reviewed the clinical and cost effectiveness of the OrthoPAT blood salvage system (Haemonetics Corp., Braintree, MA) following total knee arthroplasty (TKA). Two-hundred-and-two patients who received the OrthoPAT system were matched to 202 controls. A second match was performed for subjects weighing <75 kg. For all matched subjects, no significant difference in allogeneic blood transfusion (ABT) rate was found between the control and study groups (p=0.55). In the subjects <75 kg, use of the OrthoPAT system almost halved the incidence of ABT; however, in this small population the result was not statistically significant (p=0...
2011: Iowa Orthopaedic Journal
Hui-Liang Shen, Zheng Li, Ming-Li Feng, Guang-le Cao
BACKGROUND: Total knee arthroplasty (TKA) is an important therapy for the treatment of various late-stage knee diseases. However, it has been observed that patients have lower hemoglobin (HB) counts postoperatively, which are significantly inconsistent with the measured blood loss. Although the concept of hidden blood loss has been presented in 2000, very little clinical attention has been paid since then. In this study, we investigated the characteristics and influential factor of hidden blood loss after TKA in treating knee osteoarthritis...
June 2011: Chinese Medical Journal
J R Gonzalez-Porras, E Colado, M P Conde, T Lopez, M J Nieto, M Corral
We have prospectively evaluated the efficacy of an individualized pre-operative blood saving protocol in elective total hip arthroplasty (THA) or total knee arthroplasty (TKA). The primary aim was to obtain a pre-operative haemoglobin (Hb) level of > or =14 g dL(-1). A reduction in requirements for allogeneic transfusion was considered the second aim. Several strategies are available for increasing pre-operative Hb levels and reducing red blood cell (RBC) transfusions following THA or TKA, but the success of these programmes depends on selecting the most appropriate treatment for each patient...
February 2009: Transfusion Medicine
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