A comparative analysis of the role of Tranexamic acid as an independent variable in reducing intraoperative blood loss in patients undergoing conventional total knee arthroplasty versus computer-assisted total knee arthroplasty

Abstract

Tranexamic acid decreases blood loss in patients undergoing TKA independent of all the other blood conserving procedures.

An accelerometer-based portable navigation system improved prosthetic alignment after total knee arthroplasty in 3D measurements

“…The estimated blood loss after the operation with the conventional technique was much less in this study than in the previous reports [12]. The blood loss after CAS-TKA was similar when compared with the canal-sealed conventional TKA in the previous reports [6]. The operation technique to cover the femoral canal in the conventional method might reduce the blood loss, and thus, there were no diference of estimated blood loss between the two groups in this study.…”

“…The favorable effects of CAS‐TKA with regards to deep venous thrombosis (DVT) and pulmonary embolism (PE) have been reported [26]. However, whether CAS‐TKA can reduce the incidence of DVT and PE is still controversial [6, 14, 17, 26].…”

Daily blood loss transition after total knee arthroplasty with topical administration of tranexamic acid: Paradoxical blood loss after action of tranexamic acid

“…The daily transition of Hb drop and the estimated blood loss were investigated over an initial 24 h (from the beginning of TKA to 24 h after TKA), from 24 h to 48 h, and from 48 h to 72 h. The blood loss was calculated using the formula developed by Nadler et al; [13][14][15][16] the formula estimates blood volume by accounting for gender, weight, and size of the patient and calculates blood loss using the patient's blood volume and Hb reduction rate. If transfusion was performed, 0.7 g/dL per 1unit (320 mL of packed red blood cells) was added to the value of Hb drop.…”

Multidisciplinary approach toward enhanced recovery after surgery for total knee arthroplasty improves outcomes

“…Certain pertinent points of ERAS implementation in patients with TKA, which is specific to these patients, are as follows: (1) Preoperative education and physical therapy decrease anxiety and the cost of treatment[ 15 , 16 ]; (2) Anesthesia techniques must aim to use neuraxial/peripheral nerve block/local anesthesia infiltration techniques with the use of multimodal opioid-sparing regimens and hypobaric intrathecal solutions to promote early mobilization with adequate pain control[ 17 - 21 ]; (3) Urinary catheter placement and postoperative urinary retention: Spinal anesthesia and prostatism are contributory factors. Opioid-sparing spinal anesthetic is regarded to be the best choice[ 22 , 23 ]; (4) Use of tranexamic acid in the intraoperative period reduces blood loss and blood component therapy[ 24 ]; (5) Early mobilization should be encouraged[ 25 ]; and (6) Orthostatic intolerance is a notorious cause of failure of ERAS protocols in patients undergoing TKA and is frequently multifactorial[ 26 ].…”