title: Reducing blood loss in primary knee arthroplasty: a prospective randomised controlled trial of tranexamic acid and fibrin spray.
abstract: 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.
authors: Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, England HA7 4LP, United Kingdom. jsm@doctors.net.uk
authors: Jamie S
authors: JS
authors: McConnell
authors: Sandeep
authors: S
authors: Shewale
authors: Niall A
authors: NA
authors: Munro
authors: Kalpesh
authors: K
authors: Shah
authors: Angela H
authors: AH
authors: Deakin
authors: Andrew W G
authors: AW
authors: Kinninmonth
mesh_terms: D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005337:Fibrin / Q000008:administration & dosage*; D005340:Fibrinogen / Q000008:administration & dosage*; D005353:Fibronectins / Q000008:administration & dosage*; D006801:Humans; D011446:Prospective Studies; D013917:Thrombin / Q000008:administration & dosage*; D014148:Tranexamic Acid / Q000008:administration & dosage*
chemical_list: D000933:Antifibrinolytic Agents; D005353:Fibronectins; D014148:Tranexamic Acid; D005337:Fibrin; D005340:Fibrinogen; D013917:Thrombin