title: [Medical and economic impact of a haemostatic sealant on the rate of transfusion after total knee arthroplasty].
abstract: OBJECTIVE
  Blood loss reduction in total knee arthroplasty (TKA) contributes to the prevention of morbidity and mortality and in the management of health care costs. Fibrin haemostatic sealant have controversial effectiveness in reducing postoperative blood loss and transfusion requirements. Our study evaluated the medical and economic benefits of this treatment with the assumption that it decreases the frequency of blood transfusion after TKA.
  
  
  METHODS
  Our single-center and randomized study included 60 patients pose unilateral primary TKA for osteoarthritis. Distribution was done in 2 groups of 30 patients each. Group 1 patients treated with a dose of 5 mL Evicel®, compared to untreated group 2. Were collected the number of patients transfused. The treatment cost was compared to the sealant cost.
  
  
  RESULTS
  Results are not statistically significant. Two patients were transfused in group 1 and 3 in group 2 (P=0.64). The treatment cost for 30 patients is 13,500 €, for a savings of cells packed at 187 €, an additional cost of 13,313 € in group 1.
  
  
  CONCLUSIONS
  The use of fibrin haemostatic sealant in TKA did not induce a significant difference in terms of blood or transfusion savings, with a significant cost. We do not recommend its routine use in TKA.
authors: Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France. Electronic address: camchouf@hotmail.com.
authors: C
authors: C
authors: Choufani
authors: Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
authors: O
authors: O
authors: Barbier
authors: Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
authors: X
authors: X
authors: Bajard
authors: Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
authors: D
authors: D
authors: Ollat
authors: Service de chirurgie orthopédique et traumatologique, hôpital d'instruction des armées Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
authors: G
authors: G
authors: Versier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee; D001803:Blood Transfusion / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000191:economics* / Q000627:therapeutic use*; D006490:Hemostatics / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D015718:Fibrin Tissue Adhesive; D006490:Hemostatics
keywords: Blood loss; Colle hémostatique de fibrine; Economic; Haemostatic fibrin sealant; Prothèse totale de genou; Saignement; Total knee arthroplasty; Transfusion; Économique