title: Postoperative blood loss management in total knee arthroplasty: a comparison of four different methods.
abstract: OBJECTIVE
  As the blood loss after the total knee arthroplasty (TKA) is not only a potentially serious medical problem but also an economical concern, the purpose of the study was to investigate the effectiveness of different combinations of knee positioning and the applied wound dressings on blood saving after TKA.
  
  
  METHODS
  A randomized controlled trial including 147 TKA-operated patients was conducted. The subjects were assigned to one of the four groups; Group 1-controls, Group 2-flexion, Group 3-flexion and compression, Group 4-compression. The main outcome measures of the study were the blood loss volumes during the procedure and in the intensive care rooms and the decreases in haemoglobin, haemotocrit and red blood cells on the first and the second postoperative day.
  
  
  RESULTS
  The MANOVA results showed no differences between the groups in any of the observed parameters. The post-hoc comparisons of the each group to the control group also revealed no influence of any of the proposed blood saving techniques on the actual blood loss.
  
  
  CONCLUSIONS
  No significant differences among the four proposed blood saving methods were determined.
authors.affiliation: University Hospital for Orthopaedic Surgery Lovran, Marsala Tita 1, 51415, Lovran, Croatia. tomislav.madjarevic@gmail.com
authors.forename: Tomislav
authors.initials: T
authors.lastname: Madarevic
authors.forename: Anton
authors.initials: A
authors.lastname: Tudor
authors.forename: Branko
authors.initials: B
authors.lastname: Sestan
authors.forename: Veljko
authors.initials: V
authors.lastname: Santic
authors.forename: Gordan
authors.initials: G
authors.lastname: Gulan
authors.forename: Tomislav
authors.initials: T
authors.lastname: Prpic
authors.forename: Lana
authors.initials: L
authors.lastname: Ruzic
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000628:therapy*; D011446:Prospective Studies; D011859:Radiography; D012016:Reference Values; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome