Effects of tranexamic acid and bipolar sealer alone or in combination in primary total knee arthroplasty: a prospective, randomized, controlled trial.
BACKGROUND
The purpose of this study was to compare 2 blood management interventions, tranexamic acid (TXA) and bipolar sealer system (BSS) used independently or in combination with a control group during primary total knee arthroplasty (TKA).


METHODS
A total of 127 TKA patients were enrolled and randomized into 4 groups: Intravenous TXA plus the BSS (N = 29, group 1); TXA only (N = 29, group 2); BSS only (N = 31, group 3); and intravenous normal saline as a control group (N = 32, group 4).


RESULTS
Changes in hemoglobin from baseline to postoperative follow-up were significantly lower among patients who received TXA plus BSS and those receiving TXA only when compared with the control. BSS only did not differ significantly when compared to the control group. In addition, TXA plus BSS was as efficacious as TXA only in preserving postoperative hemoglobin.


CONCLUSIONS
In other terms, using bipolar sealer did not add to the effect of TXA in reducing the postoperative hemoglobin drop in primary TKA.
Department of Anesthesia, Eastern Maine Medical Center, Bangor, ME, USA.
Alexandru
A
Seviciu
Transfusion Services, Eastern Maine Medical Center, Bangor, ME, USA.
Irwin
I
Gross
Clinical Research Center, Eastern Maine Medical Center, Bangor, ME, USA.
Samreen
S
Fathima
Department of Orthopedics, Eastern Maine Medical Center, Bangor, ME, USA; Down East Orthopedics, Bangor, ME, USA.
Stephen M
SM
Walsh
Bipolar sealer system; Blood loss; Hemoglobin change; Total knee arthroplasty; Tranexamic acid