The Journal of arthroplasty
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Diaphyseal bowing may compromise axial alignment in revision total knee arthroplasty (TKA). 277 patients undergoing revision TKA were evaluated for coronal bowing and hip-knee-ankle (HKA) axis. The mean femoral bow was 1.52° ± 0.18° varus (-10.1° to +8.4°). The mean tibial bow was 1.25° ± 0.13° valgus (-5.9° to +10°). ⋯ Inter-rater and intra-rater reliability was high. Femoral bow greater than 4° significantly correlated with postoperative HKA axis malalignment (r = 0.402, P = 0.008). 39.7% of patients deviated 3° or greater from a neutral mechanical axis with a significant difference in femoral bow (0.94° ± 0.31°, P = 0.003). Diaphyseal bowing clearly has an important effect on postoperative limb alignment in revision TKA.
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Randomized Controlled Trial Comparative Study
Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty.
Tranexamic acid is an antifibrinolytic drug used widely to prevent bleeding. Its use in reducing bleeding during total knee arthroplasty surgery is well proven but there is no final consensus regarding the regimen. ⋯ Intra-articular tranexamic acid was used in 40 patients during the surgery. We concluded that intra-articular tranexamic acid is equally effective as three dose intravenous regimen in reducing blood loss during total knee arthroplasty surgery.
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This study aims to describe the timing, cause of death, and excess surgical mortality associated with primary total hip arthroplasty when compared to a population awaiting primary total hip arthroplasty. Mortality rates were calculated at cutoffs of 30 and 90 days post-operation or following the addition to the waiting list. ⋯ An excess surgical mortality of 0.256% at 30 days (P = 0.002) and 0.025% at 90 days post-operation (P = 0.892), unaffected by age or gender, was seen with myocardial infarction and pneumonia the cause of death in the majority of cases. By using a more appropriate control population, an excess surgical mortality at 30 days post-operation is demonstrated; the effect diminishes at 90 days post-operation.
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Randomized Controlled Trial Comparative Study
Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty: a prospective randomized study.
The purpose of this study was to compare the efficacy of topical Tranexamic Acid (TXA) versus Intravenous (IV) Tranexamic Acid for reduction of blood loss following primary total knee arthroplasty (TKA). This prospective randomized study involved 89 patients comparing topical administration of 2.0g TXA, versus IV administration of 10mg/kg. There were no differences between the two groups with regard to patient demographics or perioperative function. ⋯ There were no statistical differences between the groups in preoperative hemoglobin level, lowest postoperative hemoglobin level, or total drain output. One patient in the topical group required blood transfusion (P = 0.342). Based on our study, topical Tranexamic Acid has similar efficacy to IV Tranexamic Acid for TKA patients.
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Randomized Controlled Trial Comparative Study
Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty.
The ideal method of providing tranexamic acid (TXA) for decreasing hemoglobin drop after TKA is still controversial. In this clinical trial, 200 patients were randomly allocated to four groups. In group 1,500 mg TXA was administered intravenously. ⋯ In group 3, 1.5 g of TXA was injected through the drain. Group 4 did not take TXA. Albeit all methods had a statistical effect on hemoglobin drop, drainage and number of transfused units when compared to controls, but intravenous injection of TXA seems to be much more effective in terms of reducing hemoglobin drop and transfused units; and what's more TXA injection by drain is more effective regarding to reducing postoperative drainage.