Download PDF
J Knee Surg 2013; 26(06): 379-386
DOI: 10.1055/s-0033-1353992
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Intraoperative Pharmacotherapeutic Blood Management Strategies in Total Knee Arthroplasty

Samik Banerjee
1   Department of Orthopedics, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Baltimore, Maryland
,
Kimona Issa
1   Department of Orthopedics, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Baltimore, Maryland
,
Robert Pivec
1   Department of Orthopedics, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Baltimore, Maryland
2   Department of Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Mark J. McElroy
1   Department of Orthopedics, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Baltimore, Maryland
,
Harpal S. Khanuja
1   Department of Orthopedics, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Baltimore, Maryland
,
Steven F. Harwin
3   Department of Orthopedic Surgery, Beth Israel Medical Center, New York, New York
,
Michael A. Mont
1   Department of Orthopedics, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

08 June 2013

01 July 2013

Publication Date:
16 August 2013 (online)

    Permissions and Reprints

Abstract

Bone and soft tissue bleeding often results in substantial amounts of blood loss following total knee arthroplasty. Multiple studies have reported that cumulative blood loss varies between 500 and 1,500 mL in primary settings. Increased perioperative blood loss frequently requires allogeneic blood transfusions to improve the hematocrit and the hemoglobin levels. However, allogeneic transfusion is associated with risks of immunosuppression, transfusion reactions, graft versus host disease, and transmission of infections. To avoid these problems and reduce costs of transfusion, multiple intraoperative pharmacotherapeutic strategies have been developed. The various pharmacotherapeutic agents currently used are tranexamic acid, epsilon-aminocaproic acid, fibrin, thrombin, lavage with epinephrine, and norepinephrine. However, the relative efficacy and the cost-effectiveness of these techniques may vary. Thus, the purpose of this study was to provide a brief overview of the relative efficacy of various intraoperative pharmacological methods currently in use for decreasing blood loss following total knee arthroplasty and describe their potential complications associated with their use.

Keywords

blood - loss - prevention - pharmacotherapy - knee - arthroplasty
 

  • References

  • 1 Berman AT, Geissele AE, Bosacco SJ. Blood loss with total knee arthroplasty. Clin Orthop Relat Res 1988; (234) 137-138
    PubMedSearch in Google Scholar
  • 2 Hays MB, Mayfield JF. Total blood loss in major joint arthroplasty. A comparison of cemented and noncemented hip and knee operations. J Arthroplasty 1988; 3 (Suppl): S47-S49
    CrossrefPubMedSearch in Google Scholar
  • 3 Rosencher N, Kerkkamp HE, Macheras G , et al; OSTHEO Investigation. Orthopedic Surgery Transfusion Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in Europe. Transfusion 2003; 43 (4) 459-469
    CrossrefPubMedSearch in Google Scholar
  • 4 Lotke PA, Faralli VJ, Orenstein EM, Ecker ML. Blood loss after total knee replacement. Effects of tourniquet release and continuous passive motion. J Bone Joint Surg Am 1991; 73 (7) 1037-1040
    PubMedSearch in Google Scholar
  • 5 Sehat KR, Evans R, Newman JH. How much blood is really lost in total knee arthroplasty? Correct blood loss management should take hidden loss into account. Knee 2000; 7 (3) 151-155
    CrossrefPubMedSearch in Google Scholar
  • 6 Jämsen E, Puolakka T, Eskelinen A , et al. Predictors of mortality following primary hip and knee replacement in the aged. A single-center analysis of 1,998 primary hip and knee replacements for primary osteoarthritis. Acta Orthop 2013; 84 (1) 44-53
    CrossrefPubMedSearch in Google Scholar
  • 7 Spahn DR. Anemia and patient blood management in hip and knee surgery: a systematic review of the literature. Anesthesiology 2010; 113 (2) 482-495
    Search in Google Scholar
  • 8 Patel KK, Patel AK, Ranjan RR, Shah AP. Transfusion associated graft versus host disease following whole blood transfusion from an unrelated donor in an immunocompetent patient. Indian J Hematol Blood Transfus 2010; 26 (3) 92-95
    CrossrefPubMedSearch in Google Scholar
  • 9 Heddle NM. Pathophysiology of febrile nonhemolytic transfusion reactions. Curr Opin Hematol 1999; 6 (6) 420-426
    CrossrefPubMedSearch in Google Scholar
  • 10 Sharma S, Sharma P, Tyler LN. Transfusion of blood and blood products: indications and complications. Am Fam Physician 2011; 83 (6) 719-724
    PubMedSearch in Google Scholar
  • 11 Eder AF, Chambers LA. Noninfectious complications of blood transfusion. Arch Pathol Lab Med 2007; 131 (5) 708-718
    PubMedSearch in Google Scholar
  • 12 Auroy Y, Lienhart A, Péquignot F, Benhamou D. Complications related to blood transfusion in surgical patients: data from the French national survey on anesthesia-related deaths. Transfusion 2007; 47 (2) (Suppl): 184S-189S , discussion 201S
    CrossrefPubMedSearch in Google Scholar
  • 13 Vamvakas EC, Moore SB, Cabanela M. Blood transfusion and septic complications after hip replacement surgery. Transfusion 1995; 35 (2) 150-156
    CrossrefPubMedSearch in Google Scholar
  • 14 Irisson E, Hémon Y, Pauly V, Parratte S, Argenson JN, Kerbaul F. Tranexamic acid reduces blood loss and financial cost in primary total hip and knee replacement surgery. Orthop Traumatol Surg Res 2012; 98 (5) 477-483
    CrossrefPubMedSearch in Google Scholar
  • 15 Sepah YJ, Umer M, Ahmad T, Nasim F, Chaudhry MU, Umar M. Use of tranexamic acid is a cost effective method in preventing blood loss during and after total knee replacement. J Orthop Surg 2011; 6: 22
    CrossrefPubMedSearch in Google Scholar
  • 16 Muñoz M, García-Erce JA, Cuenca J. Tranexamic acid for reducing transfusion requirements after total knee arthroplasty: can efficacy and cost ratios be improved?. Vox Sang 2008; 95 (4) 350-351 , author reply 352
    CrossrefPubMedSearch in Google Scholar
  • 17 Bernasek TL, Burris RB, Fujii H, Levering MF, Polikandriotis JA, Patterson JJ. Effect on blood loss and cost-effectiveness of pain cocktails, platelet-rich plasma, or fibrin sealant after total knee arthroplasty. J Arthroplasty 2012; 27 (8) 1448-1451
    CrossrefPubMedSearch in Google Scholar
  • 18 Vigna-Taglianti F, Basso L, Rolfo P , et al. Tranexamic acid for reducing blood transfusions in arthroplasty interventions: a cost-effective practice. Eur J Orthop Surg Traumatol 2013; (Apr) 30
    PubMedSearch in Google Scholar
  • 19 Tai TW, Chang CW, Lai KA, Lin CJ, Yang CY. Effects of tourniquet use on blood loss and soft-tissue damage in total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am 2012; 94 (24) 2209-2215
    CrossrefPubMedSearch in Google Scholar
  • 20 Alcelik I, Pollock RD, Sukeik M, Bettany-Saltikov J, Armstrong PM, Fismer P. A comparison of outcomes with and without a tourniquet in total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. J Arthroplasty 2012; 27 (3) 331-340
    CrossrefPubMedSearch in Google Scholar
  • 21 Harvey EJ, Leclerc J, Brooks CE, Burke DL. Effect of tourniquet use on blood loss and incidence of deep vein thrombosis in total knee arthroplasty. J Arthroplasty 1997; 12 (3) 291-296
    CrossrefPubMedSearch in Google Scholar
  • 22 Stroh DA, Johnson AJ, Mont MA, Bonutti PM. Excellent clinical outcomes in total knee arthroplasty performed without a tourniquet. Surg Technol Int 2011; XXI: 189-193
    PubMedSearch in Google Scholar
  • 23 Juelsgaard P, Møller M, Larsen U. Preoperative Acute Normovolaemic Hemodilution (ANH) in combination with Hypotensive Epidural Anaesthesia (HEA) during knee arthroplasty surgery. No effect on transfusion rate. A randomized controlled trial [ISRCTN87597684]. BMC Anesthesiol 2002; 2 (1) 1
    CrossrefPubMedSearch in Google Scholar
  • 24 Kiss H, Raffl M, Neumann D, Hutter J, Dorn U. Epinephrine-augmented hypotensive epidural anesthesia replaces tourniquet use in total knee replacement. Clin Orthop Relat Res 2005; (436) 184-189
    PubMedSearch in Google Scholar
  • 25 Umlas J, Jacobson MS, Kevy SV. Survival and half-life of red cells salvaged after hip and knee replacement surgery. Transfusion 1993; 33 (7) 591-593
    CrossrefPubMedSearch in Google Scholar
  • 26 Rizzi L, Bertacchi P, Ghezzi LM, Bellavita P, Scudeller G. Postoperative blood salvage in hip and knee arthroplasty. A prospective study on cost effectiveness in 161 patients. Acta Orthop Scand 1998; 69 (1) 31-34
    PubMedSearch in Google Scholar
  • 27 Newman JH, Bowers M, Murphy J. The clinical advantages of autologous transfusion. A randomized, controlled study after knee replacement. J Bone Joint Surg Br 1997; 79 (4) 630-632
    CrossrefPubMedSearch in Google Scholar
  • 28 Singh VK, Singh PK, Javed S, Kumar K, Tomar J. Autologous transfusion of drain contents in elective primary knee arthroplasty: its value and relevance. Blood Transfus 2011; 9 (3) 281-285
    PubMedSearch in Google Scholar
  • 29 Sarkanović ML, Gvozdenović L, Savić D, Ilić MP, Jovanović G. Autologous blood transfusion in total knee replacement surgery. Vojnosanit Pregl 2013; 70 (3) 274-278
    CrossrefPubMedSearch in Google Scholar
  • 30 Park KH, Lee SR, Jin JM, Moon MS. The efficacy and safety of postoperative autologous transfusion of filtered shed blood and anticoagulant prophylaxis in total knee arthroplasty patients. Knee Surg Relat Res 2012; 24 (1) 14-18
    CrossrefPubMedSearch in Google Scholar
  • 31 Tellisi N, Kakwani R, Hulse N, Abusitta G, Ashammakhi N, Wahab KA. Autologous blood transfusion following total knee arthroplasty: is it always necessary?. Int Orthop 2006; 30 (5) 412-414
    CrossrefPubMedSearch in Google Scholar
  • 32 Harwin SF, Issa K, Naziri Q, Pivec R, Johnson AJ, Mont MA. Excellent Results of Revision TKA in Jehovah's Witness Patients. J Knee Surg 2012; (Sep) 21
    PubMedSearch in Google Scholar
  • 33 Tzonos T, Giromini D. Aprotinin for intraoperative haemostasis. Neurosurg Rev 1981; 4 (4) 193-194
    CrossrefPubMedSearch in Google Scholar
  • 34 Kim TK, Chang CB, Koh IJ. Practical issues for the use of tranexamic acid in total knee arthroplasty: a systematic review. Knee Surg Sports Traumatol Arthrosc 2013; (Mar) 31
    PubMedSearch in Google Scholar
  • 35 Gillette BP, DeSimone LJ, Trousdale RT, Pagnano MW, Sierra RJ. Low risk of thromboembolic complications with tranexamic acid after primary total hip and knee arthroplasty. Clin Orthop Relat Res 2013; 471 (1) 150-154
    CrossrefPubMedSearch in Google Scholar
  • 36 Zhang H, Chen J, Chen F, Que W. The effect of tranexamic acid on blood loss and use of blood products in total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc 2012; 20 (9) 1742-1752
    CrossrefPubMedSearch in Google Scholar
  • 37 Kagoma YK, Crowther MA, Douketis J, Bhandari M, Eikelboom J, Lim W. Use of antifibrinolytic therapy to reduce transfusion in patients undergoing orthopedic surgery: a systematic review of randomized trials. Thromb Res 2009; 123 (5) 687-696
    CrossrefPubMedSearch in Google Scholar
  • 38 Onodera T, Majima T, Sawaguchi N, Kasahara Y, Ishigaki T, Minami A. Risk of deep venous thrombosis in drain clamping with tranexamic acid and carbazochrome sodium sulfonate hydrate in total knee arthroplasty. J Arthroplasty 2012; 27 (1) 105-108
    CrossrefPubMedSearch in Google Scholar
  • 39 Sundström A, Seaman H, Kieler H, Alfredsson L. The risk of venous thromboembolism associated with the use of tranexamic acid and other drugs used to treat menorrhagia: a case-control study using the General Practice Research Database. BJOG 2009; 116 (1) 91-97
    CrossrefPubMedSearch in Google Scholar
  • 40 Camarasa MA, Olle G, Serra-Prat M , et al. Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial. Br J Anaesth 2006; 96 (5) 576-582
    CrossrefPubMedSearch in Google Scholar
  • 41 Sabatini L, Trecci A, Imarisio D, Uslenghi MD, Bianco G, Scagnelli R. Fibrin tissue adhesive reduces postoperative blood loss in total knee arthroplasty. J Orthop Traumatol 2012; 13 (3) 145-151
    CrossrefPubMedSearch in Google Scholar
  • 42 Molloy DO, Archbold HA, Ogonda L, McConway J, Wilson RK, Beverland DE. Comparison of topical fibrin spray and tranexamic acid on blood loss after total knee replacement: a prospective, randomised controlled trial. J Bone Joint Surg Br 2007; 89 (3) 306-309
    PubMedSearch in Google Scholar
  • 43 Wang GJ, Hungerford DS, Savory CG , et al. Use of fibrin sealant to reduce bloody drainage and hemoglobin loss after total knee arthroplasty: a brief note on a randomized prospective trial. J Bone Joint Surg Am 2001; 83-A (10) 1503-1505
    PubMedSearch in Google Scholar
  • 44 Notarnicola A, Moretti L, Martucci A , et al. Comparative efficacy of different doses of fibrin sealant to reduce bleeding after total knee arthroplasty. Blood Coagul Fibrinolysis 2012; 23 (4) 278-284
    CrossrefPubMedSearch in Google Scholar
  • 45 Anderson LA, Engel GM, Bruckner JD, Stoddard GJ, Peters CL. Reduced blood loss after total knee arthroplasty with local injection of bupivacaine and epinephrine. J Knee Surg 2009; 22 (2) 130-136
    Thieme ConnectPubMedSearch in Google Scholar
  • 46 Lombardi Jr AV, Berend KR, Mallory TH, Dodds KL, Adams JB. Soft tissue and intra-articular injection of bupivacaine, epinephrine, and morphine has a beneficial effect after total knee arthroplasty. Clin Orthop Relat Res 2004; (428) 125-130
    PubMedSearch in Google Scholar
  • 47 Risberg B. The response of the fibrinolytic system in trauma. Acta Chir Scand Suppl 1985; 522: 245-271
    PubMedSearch in Google Scholar
  • 48 Umanskiĭ MA. [Mechanisms of the activation of the fibrinolytic system during surgical operations]. Probl Gematol Pereliv Krovi 1971; 16 (8) 33-37
    PubMedSearch in Google Scholar
  • 49 Raza I, Davenport R, Rourke C , et al. The incidence and magnitude of fibrinolytic activation in trauma patients. J Thromb Haemost 2013; 11 (2) 307-314
    CrossrefPubMedSearch in Google Scholar
  • 50 Andersson L, Nilsson IM, Olow B. Fibrinolytic activity in man during surgery. Thromb Diath Haemorrh 1962; 7: 391-403
    PubMedSearch in Google Scholar
  • 51 Murakami F. [Significance of fibrinolytic enzymes in surgery]. Chiryo 1962; 44: 2155-2165
    PubMedSearch in Google Scholar
  • 52 Samama M, Weiss M, Yver J, Dubost C, Marchal G. [Fibrinolytic hyperactivity in 280 open-heart surgery patients. Clinical correlations and therapeutic results]. Transfusion (Paris) 1963; 6: 459-464
    CrossrefPubMedSearch in Google Scholar
  • 53 Trinidad JC. Fibrinolytic Hemorrhage in General Surgery. Philipp J Surg Surg Spec 1963; 18: 197-202
    PubMedSearch in Google Scholar
  • 54 McNicol GP, Douglas AS. Acute Fibrinolytic States in Surgery. Proc R Soc Med 1965; 58: 259-261
    PubMedSearch in Google Scholar
  • 55 Kinzel V, Shakespeare D, Derbyshire D. The effect of aprotinin on blood loss in bilateral total knee arthroplasty. Knee 2005; 12 (2) 107-111
    CrossrefPubMedSearch in Google Scholar
  • 56 Opella SJ, Wise WB, DiVerdi JA. Deoxyribonucleic acid dynamics from phosphorus-31 nuclear magnetic resonance. Biochemistry 1981; 20 (2) 284-290
    CrossrefPubMedSearch in Google Scholar
  • 57 Allison PM, Whitten CW. What is the mechanism of action of aprotinin?. Anesthesiology 1991; 75 (2) 377-379
    PubMedSearch in Google Scholar
  • 58 Fussi F. Aprotinin: mechanism of action and therapeutical uses. Boll Chim Farm 1980; 119 (11) 631-646
    PubMedSearch in Google Scholar
  • 59 Deysine M, Cliffton EE. Mechanism of Action of Epsilon Aminocaproic Acid in the Control of Hemorrhage. Ann N Y Acad Sci 1964; 115: 291-297
    CrossrefPubMedSearch in Google Scholar
  • 60 Lukasiewicz H, Niewiarowski S. In vivo studies on the mechanism of the antifibrinolytic action of E-aminocaproic acid (EACA). Thromb Diath Haemorrh 1968; 19 (3) 584-592
    PubMedSearch in Google Scholar
  • 61 Huang H, Ding W, Su Z, Zhang W. Mechanism of the preserving effect of aprotinin on platelet function and its use in cardiac surgery. J Thorac Cardiovasc Surg 1993; 106 (1) 11-18
    PubMedSearch in Google Scholar
  • 62 Hoylaerts M, Lijnen HR, Collen D. Studies on the mechanism of the antifibrinolytic action of tranexamic acid. Biochim Biophys Acta 1981; 673 (1) 75-85
    CrossrefPubMedSearch in Google Scholar
  • 63 Thorpe CM, Murphy WG, Logan M. Use of aprotinin in knee replacement surgery. Br J Anaesth 1994; 73 (3) 408-410
    CrossrefPubMedSearch in Google Scholar
  • 64 Alshryda S, Sarda P, Sukeik M, Nargol A, Blenkinsopp J, Mason JM. Tranexamic acid in total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Br 2011; 93 (12) 1577-1585
    CrossrefPubMedSearch in Google Scholar
  • 65 Odabaş AR, Cetinkaya R, Selçuk Y, Kaya H, Coşkun U. Tranexamic-acid-induced acute renal cortical necrosis in a patient with haemophilia A. Nephrol Dial Transplant 2001; 16 (1) 189-190
    CrossrefPubMedSearch in Google Scholar
  • 66 Martin K, Knorr J, Breuer T , et al. Seizures after open heart surgery: comparison of ε-aminocaproic acid and tranexamic acid. J Cardiothorac Vasc Anesth 2011; 25 (1) 20-25
    CrossrefPubMedSearch in Google Scholar
  • 67 Andersson L, Eriksson O, Hedlund PO, Kjellman H, Lindqvist B. Special considerations with regard to the dosage of tranexamic acid in patients with chronic renal diseases. Urol Res 1978; 6 (2) 83-88
    CrossrefPubMedSearch in Google Scholar
  • 68 Manji RA, Grocott HP, Leake J , et al. Seizures following cardiac surgery: the impact of tranexamic acid and other risk factors. Can J Anaesth 2012; 59 (1) 6-13
    PubMedSearch in Google Scholar
  • 69 Manjunath G, Fozailoff A, Mitcheson D, Sarnak MJ. Epsilon-aminocaproic acid and renal complications: case report and review of the literature. Clin Nephrol 2002; 58 (1) 63-67
    PubMedSearch in Google Scholar
  • 70 Liskiewicz Z, Maj S, Ziemski JM. [Renal complications during treatment of hematuria in hemophilia A with epsilon-aminocaproic acid (EACA)]. Pol Tyg Lek 1971; 26 (4) 145-147
    PubMedSearch in Google Scholar
  • 71 Bergin JJ. The complications of therapy with epsilon-aminocaproic acid. Med Clin North Am 1966; 50 (6) 1669-1678
    PubMedSearch in Google Scholar
  • 72 Galassi G, Gibertoni M, Corradini L, Colombo A. Why may epsilon-aminocaproic acid (EACA) induce myopathy in man? Report of a case and literature review. Ital J Neurol Sci 1983; 4 (4) 489-492
    CrossrefPubMedSearch in Google Scholar
  • 73 Biswas CK, Milligan DA, Agte SD, Kenward DH, Tilley PJ. Acute renal failure and myopathy after treatment with aminocaproic acid. BMJ 1980; 281 (6233) 115-116
    PubMedSearch in Google Scholar
  • 74 Colwell Jr CW, Chelly JE, Murkin JM , et al. Randomized study of aprotinin effect on transfusions and blood loss in primary THA. Clin Orthop Relat Res 2007; 465: 189-195
    PubMedSearch in Google Scholar
  • 75 Petsatodis G, Samoladas E, Christodoulou A, Hatzokos I, Pournaras I. Does aprotinin reduce blood loss in total hip arthroplasty?. Orthopedics 2006; 29 (1) 75-77
    PubMedSearch in Google Scholar
  • 76 Kokoszka A, Kuflik P, Bitan F, Casden A, Neuwirth M. Evidence-based review of the role of aprotinin in blood conservation during orthopaedic surgery. J Bone Joint Surg Am 2005; 87 (5) 1129-1136
    CrossrefPubMedSearch in Google Scholar
  • 77 Jeserschek R, Clar H, Aigner C, Rehak P, Primus B, Windhager R. Reduction of blood loss using high-dose aprotinin in major orthopaedic surgery: a prospective, double-blind, randomised and placebo-controlled study. J Bone Joint Surg Br 2003; 85 (2) 174-177
    CrossrefPubMedSearch in Google Scholar
  • 78 Engel JM, Hohaus T, Ruwoldt R, Menges T, Jürgensen I, Hempelmann G. Regional hemostatic status and blood requirements after total knee arthroplasty with and without tranexamic acid or aprotinin. Anesth Analg 2001; 92 (3) 775-780
    CrossrefPubMedSearch in Google Scholar
  • 79 Fleischmann F, Matuschek C, Orth K , et al. Aprotinin and classic wound drainage are unnecessary in total hip replacement - a prospective randomized trial. Eur J Med Res 2011; 16 (1) 20-28
    CrossrefPubMedSearch in Google Scholar
  • 80 Kristeller JL, Roslund BP, Stahl RF. Benefits and risks of aprotinin use during cardiac surgery. Pharmacotherapy 2008; 28 (1) 112-124
    CrossrefPubMedSearch in Google Scholar
  • 81 Slaughter TF, Greenberg CS. Antifibrinolytic drugs and perioperative hemostasis. Am J Hematol 1997; 56 (1) 32-36
    CrossrefPubMedSearch in Google Scholar
  • 82 Akizuki S, Yasukawa Y, Takizawa T. A new method of hemostasis for cementless total knee arthroplasty. Bull Hosp Jt Dis 1997; 56 (4) 222-224
    PubMedSearch in Google Scholar
  • 83 Kluba T, Fiedler K, Kunze B, Ipach I, Suckel A. Fibrin sealants in orthopaedic surgery: practical experiences derived from use of QUIXIL® in total knee arthroplasty. Arch Orthop Trauma Surg 2012; 132 (8) 1147-1152
    CrossrefPubMedSearch in Google Scholar
  • 84 Massin P, Scemama C, Jeanrot C, Boyer P. Does fibrin sealant use in total knee replacement reduce transfusion rates? A non-randomised comparative study. Orthop Traumatol Surg Res 2012; 98 (2) 180-185
    CrossrefPubMedSearch in Google Scholar
  • 85 Skovgaard C, Holm B, Troelsen A , et al. No effect of fibrin sealant on drain output or functional recovery following simultaneous bilateral total knee arthroplasty: a randomized, double-blind, placebo-controlled study. Acta Orthop 2013; 84 (2) 153-158
    CrossrefPubMedSearch in Google Scholar
  • 86 Beierlein W, Scheule AM, Antoniadis G, Braun C, Schosser R. An immediate, allergic skin reaction to aprotinin after reexposure to fibrin sealant. Transfusion 2000; 40 (3) 302-305
    CrossrefPubMedSearch in Google Scholar
  • 87 Patel S, Rodriguez-Merchan EC, Haddad FS. The use of fibrin glue in surgery of the knee. J Bone Joint Surg Br 2010; 92 (10) 1325-1331
    CrossrefPubMedSearch in Google Scholar
  • 88 Hino M, Ishiko O, Honda KI , et al. Transmission of symptomatic parvovirus B19 infection by fibrin sealant used during surgery. Br J Haematol 2000; 108 (1) 194-195
    CrossrefPubMedSearch in Google Scholar
  • 89 Morita Y, Nishii O, Kido M, Tsutsumi O. Parvovirus infection after laparoscopic hysterectomy using fibrin glue hemostasis. Obstet Gynecol 2000; 95 (6 Pt 2) 1026
    CrossrefPubMedSearch in Google Scholar
  • 90 Honda K, Ishiko O, Tsujimura A , et al. Neutropenia accompanying parvovirus B19 infection after gynecologic surgery. Acta Haematol 2000; 103 (4) 186-190
    CrossrefPubMedSearch in Google Scholar
  • 91 Horowitz B, Busch M. Estimating the pathogen safety of manufactured human plasma products: application to fibrin sealants and to thrombin. Transfusion 2008; 48 (8) 1739-1753
    CrossrefPubMedSearch in Google Scholar
  • 92 Kusuma SK, Sheridan KC, Wasielewski RC. Use of bovine thrombin to reduce blood loss in primary total knee arthroplasty: a controlled randomized trial. J Arthroplasty 2013; (Mar) 18
    PubMedSearch in Google Scholar
  • 93 Kim HJ, Fraser MR, Kahn B, Lyman S, Figgie MP. The efficacy of a thrombin-based hemostatic agent in unilateral total knee arthroplasty: a randomized controlled trial. J Bone Joint Surg Am 2012; 94 (13) 1160-1165
    CrossrefPubMedSearch in Google Scholar
  • 94 Gasparini G, Papaleo P, Pola P, Cerciello S, Pola E, Fabbriciani C. Local infusion of norepinephrine reduces blood losses and need of transfusion in total knee arthroplasty. Int Orthop 2006; 30 (4) 253-256
    CrossrefPubMedSearch in Google Scholar
  • 95 Malone KJ, Matuszak S, Mayo D, Greene P. The effect of intra-articular epinephrine lavage on blood loss following total knee arthroplasty. Orthopedics 2009; 32 (2) 100
    PubMedSearch in Google Scholar
  • 96 Mazzocca AD, Meneghini RM, Chhablani R, Badrinath SK, Cole BJ, Bush-Joseph CA. Epinephrine-induced pulmonary edema during arthroscopic knee surgery. A case report. J Bone Joint Surg Am 2003; 85-A (5) 913-915
    PubMedSearch in Google Scholar
  • 97 Yamada K, Imaizumi T, Uemura M, Takada N, Kim Y. Comparison between 1-hour and 24-hour drain clamping using diluted epinephrine solution after total knee arthroplasty. J Arthroplasty 2001; 16 (4) 458-462
    CrossrefPubMedSearch in Google Scholar