Skip to main content
Top
Published in: Journal of Orthopaedics and Traumatology 3/2012

Open Access 01-09-2012 | Original Article

Fibrin tissue adhesive reduces postoperative blood loss in total knee arthroplasty

Authors: Luigi Sabatini, Andrea Trecci, Daniele Imarisio, Marco Davide Uslenghi, Giuseppe Bianco, Roberto Scagnelli

Published in: Journal of Orthopaedics and Traumatology | Issue 3/2012

Login to get access

Abstract

Background

Blood transfusion is often required in total knee replacement; various methods of blood preservation have been studied. The best solution is to reduce the loss of blood during and after surgery.

Materials and methods

We designed this study to evaluate the hemostatic efficacy and safety of fibrin tissue adhesive (Quixil) in patients receiving total knee arthroplasty [low contact stress (LCS, DePuy, Warsaw, IN, US) cementless total knee replacement (TKR)] with a prospective, randomized, standard treatment controlled study. Thirty-five patients were randomized to receive treatment with fibrin tissue adhesive (treatment group), and 35 were randomized to be managed with postoperative blood recovery and reinfusion (control group). Blood loss in suction drain, decrease in hemoglobin values, and transfusions were recorded.

Results

A significant reduction in apparent total blood loss was detected in the treatment group compared with the control group. There was also a lower decrease in hemoglobin level, although this difference was not significant. When fibrin tissue adhesive was administered, the need for transfusions was lower. No major adverse events were recorded in our series.

Conclusions

Fibrin tissue adhesive reduced blood loss in TKR and seemed to significantly reduce the need for blood transfusion. Fibrin tissue adhesive can be an appropriate solution to enhance hemostasis and vessel sealing at the operative site in TKR, in order to reduce blood loss after surgery and the risk of complications.
Literature
1.
go back to reference Berman AT, Geissele AE, Bosacco SJ (1988) Blood loss with total knee arthroplasty. Clin Orthop 234:137–138PubMed Berman AT, Geissele AE, Bosacco SJ (1988) Blood loss with total knee arthroplasty. Clin Orthop 234:137–138PubMed
2.
go back to reference Everts PA, Davilee RJ, Oosterbos CJ et al (2007) Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis. Knee Surg Sports Traumatol Arthrosc 15(7):888–894PubMedCrossRef Everts PA, Davilee RJ, Oosterbos CJ et al (2007) Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis. Knee Surg Sports Traumatol Arthrosc 15(7):888–894PubMedCrossRef
3.
go back to reference Curtin WA, Wang GJ, Goodman NC, Abbott RD, Spotnitz WD (1999) Reduction of hemorrhage after knee arthroplasty using cryo-based fibrin sealant. J Arthroplasty 14(4):481–487PubMedCrossRef Curtin WA, Wang GJ, Goodman NC, Abbott RD, Spotnitz WD (1999) Reduction of hemorrhage after knee arthroplasty using cryo-based fibrin sealant. J Arthroplasty 14(4):481–487PubMedCrossRef
4.
go back to reference Flynn JC, Csenesitz TA (1979) Present status of intraoperative blood recovery during orthopaedics surgery. Jefferson Orthop J 8:22–25 Flynn JC, Csenesitz TA (1979) Present status of intraoperative blood recovery during orthopaedics surgery. Jefferson Orthop J 8:22–25
5.
go back to reference Cowell H.R (1937) Editorial. Prior deposit of autologous blood for transfusion. J Bone Joint Surg 69A:319 Cowell H.R (1937) Editorial. Prior deposit of autologous blood for transfusion. J Bone Joint Surg 69A:319
6.
go back to reference Wang GJ, Hungerford DS, Savory CG (2001) Use of fibrin sealant to reduce bloody drainage and haemoglobin loss after total knee arthroplasty. J Bone Joint Surg 83A(10):1503–1505 Wang GJ, Hungerford DS, Savory CG (2001) Use of fibrin sealant to reduce bloody drainage and haemoglobin loss after total knee arthroplasty. J Bone Joint Surg 83A(10):1503–1505
7.
go back to reference Hynes M, Calder P, Scott G (2003) The use of tranexamic acid to reduce blood loss during total knee arthroplasty. Knee 10:375–377PubMedCrossRef Hynes M, Calder P, Scott G (2003) The use of tranexamic acid to reduce blood loss during total knee arthroplasty. Knee 10:375–377PubMedCrossRef
8.
go back to reference Levy O, Martinowitz U, Oran A (1999) The use of fibrin tissue adhesive to reduce blood loss and the need for blood transfusion after total knee arthroplasty. J Bone Joint Surg 81A(11):1580–1588 Levy O, Martinowitz U, Oran A (1999) The use of fibrin tissue adhesive to reduce blood loss and the need for blood transfusion after total knee arthroplasty. J Bone Joint Surg 81A(11):1580–1588
9.
go back to reference Patel S, Rodriguez Merchan EC, Haddad FS (2010) The use of fibrin glue in surgery of the knee. JBJS (Br) 92B:1325–1331 Patel S, Rodriguez Merchan EC, Haddad FS (2010) The use of fibrin glue in surgery of the knee. JBJS (Br) 92B:1325–1331
10.
go back to reference Wang GJ, Goldthwaite CA Jr, Burks SG, Spotniz WD (2003) Experience improves successful use of fibrin sealant in total knee arthroplasty: implication for surgical education. J Long Term Eff Med Implants 13(5):389–397PubMedCrossRef Wang GJ, Goldthwaite CA Jr, Burks SG, Spotniz WD (2003) Experience improves successful use of fibrin sealant in total knee arthroplasty: implication for surgical education. J Long Term Eff Med Implants 13(5):389–397PubMedCrossRef
11.
go back to reference Kohno H, Nagasue N, Chang YC et al (1992) Comparison of topical hemostatic agents in elective hepatic resection: a clinical prospective randomized trial. World J Surg 16:966–970PubMedCrossRef Kohno H, Nagasue N, Chang YC et al (1992) Comparison of topical hemostatic agents in elective hepatic resection: a clinical prospective randomized trial. World J Surg 16:966–970PubMedCrossRef
12.
go back to reference Blackwell Science Ltd (2001) Guidelines for the clinical use of red cell transfusions. Br J Haematol 113:24–31CrossRef Blackwell Science Ltd (2001) Guidelines for the clinical use of red cell transfusions. Br J Haematol 113:24–31CrossRef
13.
go back to reference Good L, Peterson E, Lisander B (2003) Tranexamic acid decreases external blood loss but not hidden blood lossin total knee replacement. Br J Anaesth 90:596–599PubMedCrossRef Good L, Peterson E, Lisander B (2003) Tranexamic acid decreases external blood loss but not hidden blood lossin total knee replacement. Br J Anaesth 90:596–599PubMedCrossRef
14.
go back to reference Sehat KR, Evans R, Newman JH (2000) How much blood is really lost in total knee arthroplasty: correct blood loss management should take hidden loss into account. Knee 7:151–155PubMedCrossRef Sehat KR, Evans R, Newman JH (2000) How much blood is really lost in total knee arthroplasty: correct blood loss management should take hidden loss into account. Knee 7:151–155PubMedCrossRef
15.
go back to reference Sehat KR, Evans R, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty: correct management of blood loss should take hidden loss into account. JBJS (Br) 86B:561–565 Sehat KR, Evans R, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty: correct management of blood loss should take hidden loss into account. JBJS (Br) 86B:561–565
16.
go back to reference Everts PAM, Devilee RJJ, Brown Mahoney C (2006) Platelet gel and fibrin sealant reduce allogenic blood transfusions in total knee arthroplasty. Acta Anaesthesiol Scand 50:593–599PubMedCrossRef Everts PAM, Devilee RJJ, Brown Mahoney C (2006) Platelet gel and fibrin sealant reduce allogenic blood transfusions in total knee arthroplasty. Acta Anaesthesiol Scand 50:593–599PubMedCrossRef
17.
go back to reference Birkmeyer JD, Goodnough LT, AuBuchon JP, Noordail PG (1993) the cost-effectiveness of postoperative autologous blood donation for total hip and knee replacement. Transfusion 33:544–551PubMedCrossRef Birkmeyer JD, Goodnough LT, AuBuchon JP, Noordail PG (1993) the cost-effectiveness of postoperative autologous blood donation for total hip and knee replacement. Transfusion 33:544–551PubMedCrossRef
18.
go back to reference Carson JL, Duff A, Poses RM et al (1996) Effect of anaemia and cardiovascular desease on surgical mortality and morbidity. Lancet 348:1055–1060PubMedCrossRef Carson JL, Duff A, Poses RM et al (1996) Effect of anaemia and cardiovascular desease on surgical mortality and morbidity. Lancet 348:1055–1060PubMedCrossRef
Metadata
Title
Fibrin tissue adhesive reduces postoperative blood loss in total knee arthroplasty
Authors
Luigi Sabatini
Andrea Trecci
Daniele Imarisio
Marco Davide Uslenghi
Giuseppe Bianco
Roberto Scagnelli
Publication date
01-09-2012
Publisher
Springer International Publishing
Published in
Journal of Orthopaedics and Traumatology / Issue 3/2012
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI
https://doi.org/10.1007/s10195-012-0198-7

Other articles of this Issue 3/2012

Journal of Orthopaedics and Traumatology 3/2012 Go to the issue