title: Use of bovine thrombin to reduce blood loss in primary total knee arthroplasty: a controlled randomized trial.
abstract: Reducing blood loss during primary total knee arthroplasty (TKA) can improve outcomes by reducing transfusion requirements and wound complications. We examined the use of bovine thrombin to augment hemostasis during primary TKA. A double-blinded randomized trial was performed with 80 primary TKA patients. Half received intraarticular bovine thrombin at the time of wound closure, and half did not. Hemoglobin levels in the study group did decline less than the control group, but no statistically significant difference was found in rates of transfusion, drain outputs, length of stay, or Knee Society scores. This agent does appear to slightly reduce blood loss, but routine use is not cost effective. Thrombin may be considered for patients who would benefit more from greater blood conservation.
authors.affiliation: Minimally Invasive Orthopedics, Grant Medical Center, Columbus, Ohio 43215, USA.
authors.forename: Sharat K
authors.initials: SK
authors.lastname: Kusuma
authors.forename: Kate C
authors.initials: KC
authors.lastname: Sheridan
authors.forename: Ray C
authors.initials: RC
authors.lastname: Wasielewski
mesh_terms: D000368:Aged; D000818:Animals; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D002417:Cattle; D004311:Double-Blind Method; D004322:Drainage / Q000706:statistics & numerical data; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006801:Humans; D007269:Injections, Intra-Arterial; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011446:Prospective Studies; D013917:Thrombin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013917:Thrombin
keywords: blood loss; hemostasis; thrombin; total knee arthroplasty