Abstract
While advances in the design and fixation of implants have improved the survival and function of total knee replacements, blood loss from the procedure remains a significant concern. It is estimated that 800 mL to 1700 mL of blood is lost during the peri-operative period of a total knee replacement. Accordingly, allogenic blood transfusion following total knee replacement has been reported to be as high as fifty percent. Transfusion of allogenic blood, however, is not without risk, and has been shown to be associated with higher rates of infection, fluid overload, and increased length of stay following total knee replacement.
Topical fibrin sprays applied to the exposed tissues and bony surfaces during total knee replacement has shown promise as an alternative hemostatic option in prior studies. By promoting hemostasis prior to tourniquet deflation, it is thought that post-operative blood loss will be reduced. In addition to reduction of total blood loss from TKA, it is possible that intra-articular hemarthrosis will be reduced, and patients may regain motion more quickly post-operatively.
The purpose of this study, therefore, was to compare the total blood volume loss in patients undergoing primary total knee arthroplasty with and without the intra-operative application of a fibrin sealant. Secondary aims included a comparison of the rate of allogenic blood transfusions, post-operative pain scores, and knee range of motion between groups.
