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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-06-2011 | Knee

Efficient strategy for controlling postoperative hemorrhage in total knee arthroplasty

Authors: Hideyuki Sasanuma, Hitoshi Sekiya, Kenzou Takatoku, Hisashi Takada, Naoya Sugimoto, Yuichi Hoshino

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2011

Abstract

Purpose

The objective of the present study was to compare the intraoperative use of tranexamic acid (TNA) plus intra-articular diluted-epinephrine (DEP) with preoperative autologous blood donations and transfusions in reducing an allogeneic blood transfusion (ABT) in primary unilateral total knee arthroplasty (TKA).

Methods

Patients (n = 133) treated with unilateral primary TKA were divided into three groups retrospectively: patients administered autologous blood transfusions were assigned to group A (n = 51); patients administered preoperative injections of TNA and postoperative intra-articular injections of DEP were assigned to group B (n = 42); and patients treated with the drain-clamp method in addition to injections of TNA and DEP were assigned to group C (n = 40). The rate of avoidance of ABTs, postoperative blood loss, and complications (DVT/PE, skin problems) were examined.

Results

The differences among the three groups were not significant in terms of the proportion of patients requiring no ABTs (94% in group A, 93% in group B and 95% in group C, n.s.). The total blood loss calculated was 1,140 ± 451 ml, 852 ± 343 ml, and 850 ± 296 ml, respectively (group B > A, group C > A, P = 0.0009). The significant complications were not observed in three groups.

Conclusion

The results of the study showed that the TNA plus DEP combination exerted a comparable effect with preoperative autologous blood transfusion in avoiding ABTs in unilateral primary TKA. Considering several problems of preoperative autologous blood donation, the use of TNA plus DEP is recommended. In addition, it is highly possible that allogeneic blood transfusions can be avoided for patients with preoperative Hb values ≥10.5 using the method described in this study, and the need for preoperative autologous blood donations can be decreased.

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Title: Efficient strategy for controlling postoperative hemorrhage in total knee arthroplasty
Authors: Hideyuki Sasanuma
Hitoshi Sekiya
Kenzou Takatoku
Hisashi Takada
Naoya Sugimoto
Yuichi Hoshino
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-010-1263-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficient strategy for controlling postoperative hemorrhage in total knee arthroplasty

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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