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The Bone & Joint Journal
Vol. 98-B, Issue 2 | Pages 173 - 178
1 Feb 2016
Sassoon A Nam D Jackups R Johnson SR Nunley RM Barrack RL

Aims

This study investigated whether the use of tranexamic acid (TXA) decreased blood loss and transfusion related cost following surface replacement arthroplasty (SRA).

Methods

A retrospective review of patients treated with TXA during a SRA, who did not receive autologous blood (TXA group) was performed. Two comparison groups were established; the first group comprised of patients who donated their own blood pre-operatively (auto group) and the second of patients who did not donate blood pre-operatively (control). Outcomes included transfusions, post-operative haemoglobin (Hgb), complications, and length of post-operative stay.


The Bone & Joint Journal
Vol. 96-B, Issue 5 | Pages 619 - 621
1 May 2014
Adelani MA Johnson SR Keeney JA Nunley RM Barrack RL

Haematomas, drainage, and other non-infectious wound complications following total knee replacement (TKR) have been associated with long-term sequelae, in particular, deep infection. However, the impact of these wound complications on clinical outcome is unknown. This study compares results in 15 patients re-admitted for wound complications within 90 days of TKR to 30 matched patients who underwent uncomplicated total knee replacements. Patients with wound complications had a mean age of 66 years (49 to 83) and mean body mass index (BMI) of 37 (21 to 54), both similar to that of patients without complications (mean age 65 years and mean BMI 35). Those with complications had lower mean Knee Society function scores (46 (0 to 100 vs 66 (20 to 100), p = 0.047) and a higher incidence of mild or greater pain (73% vs 33%, p = 0.01) after two years compared with the non re-admitted group. Expectations in patients with wound complications following TKR should be tempered, even in those who do not develop an infection.

Cite this article: Bone Joint J 2014;96-B:619–21.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_II | Pages 106 - 106
1 Feb 2003
Russell ID Baker D Johnson SR
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Arthroscopic lavage is commonly used in the management of mild to moderate arthritis of the knee. In the last few years the use of Hyaluronic Acid and its derivatives has become popular in the management of this same group of patients. The study was set up to establish whether Synvisc (HylanGF-20) produced equivalent or improved symptomatic relief when compared to arthroscopic lavage.

A prospective randomised trial. Fifty patients with knee OA were randomly allocated to either the arthroscopic lavage or Synvisc group. All patients were assessed prior to treatment using the WOMAC knee evaluation questionnaire, and further assessments were made at 6 weeks, 3 months, 6 months and one year post treatment.

The Synvisc group showed greater and more consistent improvement in WOMAC scores than the lavage group at all assessments post treatment. The difference between the treatment groups was statistically significant at 6 months (p< 0. 05) and at 1 Year (p=0. 0018).

We conclude that a course of Synvisc injections can be administered on an out-patient basis and is a safer, more cost-effective and more reliable treatment for Knee OA compared to arthroscopic lavage.