title: Prospective, randomized trial to evaluate efficacy of a thrombin-based hemostatic agent in total knee arthroplasty.
abstract: Total knee arthroplasty (TKA) can be associated with substantial blood loss, leading to increased morbidity and transfusion rates. The study objective was to evaluate routine use of a thrombin-based topical hemostatic matrix in reducing blood loss and transfusion requirements in primary TKA. 108 patients were enrolled in a prospective, randomized, single-center trial. Patients receiving the hemostatic agent demonstrated a lower mean calculated blood loss (1325.2±464.8mL vs. control, 1509.3±432.8mL; P=0.02), drain output (415.6±202.0mL vs. control, 579.9±306.7mL; P=0.008), and length of stay (3.3±0.8days vs. control, 3.7±1.1days; P=0.03), without a statistically significant difference in mean hemoglobin loss or transfusion requirements. The clinical utility of this hemostatic agent to reduce transfusions after uncomplicated, primary TKA continues to remain unclear.
authors.affiliation: Cleveland Clinic Florida, Department of Orthopedic Surgery, 2950 Cleveland, Clinic Blvd, Weston, FL 33331.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Suarez
authors.affiliation: Cleveland Clinic Florida, Department of Orthopedic Surgery, 2950 Cleveland, Clinic Blvd, Weston, FL 33331.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Slotkin
authors.affiliation: Cleveland Clinic Florida, Department of Orthopedic Surgery, 2950 Cleveland, Clinic Blvd, Weston, FL 33331.
authors.forename: Andres M
authors.initials: AM
authors.lastname: Alvarez
authors.affiliation: Cleveland Clinic, Department of Orthopedic Surgery, 9500 Euclid Avenue, Cleveland, OH 44195.
authors.forename: Caleb R
authors.initials: CR
authors.lastname: Szubski
authors.affiliation: Cleveland Clinic, Department of Orthopedic Surgery, 9500 Euclid Avenue, Cleveland, OH 44195.
authors.forename: Wael K
authors.initials: WK
authors.lastname: Barsoum
authors.affiliation: Cleveland Clinic Florida, Department of Orthopedic Surgery, 2950 Cleveland, Clinic Blvd, Weston, FL 33331.
authors.forename: Preetesh D
authors.initials: PD
authors.lastname: Patel
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001168:Arthritis / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage*; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D013917:Thrombin / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: C411004:FloSeal Matrix; D006490:Hemostatics; D013917:Thrombin
keywords: Floseal; Total knee arthroplasty; blood conservation; blood management; hemostatic agent; transfusion