BIOMAT Database Logo BIOMAT Database Logo

Reducing blood loss in primary knee arthroplasty: a prospective randomised controlled trial of tranexamic acid and fibrin spray. 2012

Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, England HA7 4LP, United Kingdom. jsm@doctors.net.uk

A prospective, randomised controlled trial compared the effects of two medications intended to reduce blood loss from total knee arthroplasty. Patients were randomised to one of the following three treatment groups: 10mg/kg tranexamic acid at given at induction of anaesthesia, 10 ml of fibrin spray administered topically during surgery, or to a control group receiving neither treatment. Sixty six patients underwent elective cemented total knee arthroplasty; computer navigation was used in all cases. There was no significant difference in blood loss between the tranexamic acid and fibrin spray groups (p=0.181). There was no significant difference in blood loss between the tranexamic acid and fibrin spray groups(p=0.181). The fibrin spray led to a significant reduction in blood loss compared to control (p=0.007). The effect of tranexamic acid did not reach significance (p=0.173). We conclude that fibrin spray was effective in reducing blood loss but that with a study of this power, we were unable to detect an effect of tranexamic acid in cemented navigated total knee replacement at the dose used.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005337 Fibrin A protein derived from FIBRINOGEN in the presence of THROMBIN, which forms part of the blood clot. Antithrombin I
D005340 Fibrinogen Plasma glycoprotein clotted by thrombin, composed of a dimer of three non-identical pairs of polypeptide chains (alpha, beta, gamma) held together by disulfide bonds. Fibrinogen clotting is a sol-gel change involving complex molecular arrangements: whereas fibrinogen is cleaved by thrombin to form polypeptides A and B, the proteolytic action of other enzymes yields different fibrinogen degradation products. Coagulation Factor I,Factor I,Blood Coagulation Factor I,gamma-Fibrinogen,Factor I, Coagulation,gamma Fibrinogen
D005353 Fibronectins Glycoproteins found on the surfaces of cells, particularly in fibrillar structures. The proteins are lost or reduced when these cells undergo viral or chemical transformation. They are highly susceptible to proteolysis and are substrates for activated blood coagulation factor VIII. The forms present in plasma are called cold-insoluble globulins. Cold-Insoluble Globulins,LETS Proteins,Fibronectin,Opsonic Glycoprotein,Opsonic alpha(2)SB Glycoprotein,alpha 2-Surface Binding Glycoprotein,Cold Insoluble Globulins,Globulins, Cold-Insoluble,Glycoprotein, Opsonic,Proteins, LETS,alpha 2 Surface Binding Glycoprotein
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000933 Antifibrinolytic Agents Agents that prevent fibrinolysis or lysis of a blood clot or thrombus. Several endogenous antiplasmins are known. The drugs are used to control massive hemorrhage and in other coagulation disorders. Antifibrinolysin,Antifibrinolysins,Antifibrinolytic,Antifibrinolytic Agent,Antiplasmin,Antiplasmins,Antifibrinolytics,Plasmin Inhibitor,Plasmin Inhibitors,Agent, Antifibrinolytic,Agents, Antifibrinolytic,Inhibitor, Plasmin,Inhibitors, Plasmin
D013917 Thrombin An enzyme formed from PROTHROMBIN that converts FIBRINOGEN to FIBRIN. Thrombase,Thrombin JMI,Thrombin-JMI,Thrombinar,Thrombostat,alpha-Thrombin,beta,gamma-Thrombin,beta-Thrombin,gamma-Thrombin,JMI, Thrombin
D014148 Tranexamic Acid Antifibrinolytic hemostatic used in severe hemorrhage. AMCHA,AMCA,Amchafibrin,Anvitoff,Cyklokapron,Exacyl,KABI 2161,Spotof,Transamin,Ugurol,t-AMCHA,trans-4-(Aminomethyl)cyclohexanecarboxylic Acid
D016063 Blood Loss, Surgical Loss of blood during a surgical procedure. Hemorrhage, Surgical,Surgical Blood Loss,Surgical Hemorrhage,Surgical Blood Losses,Surgical Hemorrhages
D019645 Arthroplasty, Replacement, Knee Replacement of the knee joint. Knee Replacement, Total,Arthroplasties, Knee Replacement,Arthroplasties, Replacement, Knee,Arthroplasty, Knee Replacement,Arthroplasty, Replacement, Partial Knee,Knee Arthroplasty,Knee Arthroplasty, Total,Knee Replacement Arthroplasties,Knee Replacement Arthroplasty,Partial Knee Arthroplasty,Partial Knee Replacement,Replacement Arthroplasties, Knee,Replacement Arthroplasty, Knee,Replacement, Total Knee,Total Knee Replacement,Unicompartmental Knee Arthroplasty,Unicompartmental Knee Replacement,Unicondylar Knee Arthroplasty,Unicondylar Knee Replacement,Arthroplasty, Knee,Arthroplasty, Partial Knee,Arthroplasty, Total Knee,Arthroplasty, Unicompartmental Knee,Arthroplasty, Unicondylar Knee,Knee Arthroplasty, Partial,Knee Arthroplasty, Unicompartmental,Knee Arthroplasty, Unicondylar,Knee Replacement, Partial,Knee Replacement, Unicompartmental,Knee Replacement, Unicondylar,Total Knee Arthroplasty

Related Publications

Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement: a prospective, randomised controlled trial.
March 2007, The Journal of bone and joint surgery. British volume,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Tranexamic acid reduces early post-operative blood loss after total knee arthroplasty: a prospective randomised controlled trial of 29 patients.
March 2006, The Knee,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Reducing blood loss in simultaneous bilateral total knee arthroplasty: combined intravenous-intra-articular tranexamic acid administration. A prospective randomized controlled trial.
March 2015, The Knee,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
[A PROSPECTIVE RANDOMIZED SELF-CONTROLLED STUDY ON EFFECT OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS IN TOTAL KNEE ARTHROPLASTY].
March 2015, Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Tranexamic acid reduces blood loss after primary shoulder arthroplasty: a double-blind, placebo-controlled, prospective, randomized controlled trial.
March 2018, JSES open access,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Effect of knee flexion position and combined application of tranexamic acid on blood loss following primary total knee arthroplasty: a prospective randomized controlled trial.
March 2018, International orthopaedics,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
EFFICACY OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS IN TOTAL KNEE ARTHROPLASTY.
January 2018, Acta ortopedica brasileira,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
A randomised controlled trial of tranexamic acid versus misoprostol in reducing blood loss during caesarean section.
June 2022, Ghana medical journal,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Topical vs Intravenous Tranexamic Acid in Reducing Blood Loss After Bilateral Total Knee Arthroplasty: A Prospective Study.
July 2016, The Journal of arthroplasty,
Jamie S McConnell, and Sandeep Shewale, and Niall A Munro, and Kalpesh Shah, and Angela H Deakin, and Andrew W G Kinninmonth
Tranexamic Acid Reduces Blood Loss and Transfusion in Patients Undergoing Total Knee Arthroplasty without Tourniquet: A Prospective Randomized Controlled Trial.
January 2014, The open orthopaedics journal,
Copied contents to your clipboard!