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Orthopaedic Proceedings
Vol. 99-B, Issue SUPP_8 | Pages 106 - 106
1 Apr 2017
Monsef J Schmidt-Braekling T Della Valle AG Parks M Sculco T Boettner F
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Background

Tranexamic acid (TXA) and fibrin sealants have gained widespread use in total knee arthroplasty. They can decrease bleeding, drainage volume, hematoma formation, and incidence of blood transfusion. However, they are costly and carry a theoretical risk of infection transmission and thrombosis. This study compares the two pharmacologic interventions to preoperative autologous blood donation as well as no intervention.

Methods

This prospective study evaluated a process change within our blood management program over the last five years. The program began initially with a comparison of only routine hemostasis compared to routine preoperative autologous blood donation (PABD) for all patients (Group 1), which then evolved into a targeted PABD protocol where only anaemic patients predonated (Group 2). Subsequently, patients received topical fibrin sealant for a year (Group 3), after which the topical TXA protocol was introduced and is still in place (Group 4).