title: Is fibrin sealant effective and safe in total knee arthroplasty? A meta-analysis of randomized trials.
abstract: The objective of this study was to evaluate the efficacy and safety of fibrin sealant in patients following total knee arthroplasty (TKA). A comprehensive literature search of the electronic databases PubMed, MEDLINE, Web of Science, and Cochrane Library for published randomized controlled trials (RCTs) was undertaken. The evidence base was critically appraised using a tool from the Cochrane Bone, Joint and Muscle Trauma Group. Eight RCTs involving 641 patients were included. The use of fibrin sealant significantly reduced postoperative drainage (weighted mean difference (WMD) -346, 95% confidence interval (CI) -496.29 to -197.54, P < 0.00001) and blood transfusions (risk ratio (RR) 0.47, 95% CI 0.35 to 0.63, P < 0.00001) and led to a significant improvement in the range of motion (WMD 16.59, 95% CI 6.92 to 26.25, P = 0.0008). However, using fibrin sealant did not significantly reduced total blood loss (WMD -305.25, 95% CI -679.44 to 68.95, P = 0.11). Regarding complications, there were no significant differences in any adverse events, fever, infection, or hematoma among the study groups. In conclusion, the present meta-analysis indicates that the use of fibrin sealant was effective and safe as a hemostatic therapy for patients with TKA.
authors.forename: Hongsheng
authors.initials: H
authors.lastname: Wang
authors.forename: Liancheng
authors.initials: L
authors.lastname: Shan
authors.forename: Hui
authors.initials: H
authors.lastname: Zeng
authors.forename: Mengxiong
authors.initials: M
authors.lastname: Sun
authors.affiliation: Department of Orthopedics, Tenth People's Hospital of Tongji University, 301 Yanchang Road, Shanghai 200072, China. Hua_yingqi@163.com.
authors.forename: Yingqi
authors.initials: Y
authors.lastname: Hua
authors.forename: Zhengdong
authors.initials: Z
authors.lastname: Cai
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D005334:Fever / Q000139:chemically induced / Q000175:diagnosis; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage* / Q000009:adverse effects; D006406:Hematoma / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome
chemical_list: D015718:Fibrin Tissue Adhesive