Knee Surg Relat Res.  2014 Dec;26(4):236-240. 10.5792/ksrr.2014.26.4.236.

Efficacy of Intra-Articular Injection of Thrombin-Based Hemostatic Agent in the Control of Bleeding after Primary Total Knee Arthroplasty

• Bae KC
• Cho CH
• Lee KJ
• Son ES
• Lee SW
• Lee SJ
• Lim KH

• KMID: 2297826
• DOI: http://doi.org/10.5792/ksrr.2014.26.4.236

Abstract

PURPOSE
To evaluate the hemostatic effect of intraarticular injection of a thrombin-based hemostatic agent in total knee arthroplasty (TKA).
MATERIALS AND METHODS
We performed a prospective randomized controlled trial on the use of a thrombin-based hemostatic agent in patients undergoing unilateral TKA. A total of 100 TKA patients were enrolled, with 50 patients randomized into the study group and the other 50 patients into the controlled group. Drain output, hemoglobin level, total red blood cell loss for 24 hours after surgery, transfusion rates, and complications were assessed.
RESULTS
Postoperative drain output was 525 mL in the study group and 667 mL in the control group (p=0.01). Nine patients in the study group and eighteen in the control group received blood transfusion (p=0.043). But, there was no significant difference between two groups in terms of hemoglobin level change and total red blood cell loss (p>0.05).
CONCLUSIONS
The thrombin-based hemostatic agent demonstrated efficacy in reducing drain output and blood transfusion rates. Thus, we believe the use of a thrombin-based hemostatic agent should be considered as an option in orthopedic surgery that involves massive bleeding.

Keyword

Knee; Osteoarthritis; Arthroplasty; Bleeding; Hemostatic agent

MeSH Terms

Arthroplasty*
Blood Transfusion
Erythrocytes
Hemorrhage*
Humans
Injections, Intra-Articular*
Knee*
Orthopedics
Osteoarthritis
Prospective Studies