Effectiveness of Fibrin Sealant after Cementless Total HIP Replacement: A Double-Blind Randomized Controlled Trial

Randelli, Filippo; Banci, Lorenzo; Ragone, Vincenza; Pavesi, Marco; Randelli, G

doi:10.1177/039463201302600118

Cited by 20 publications

(10 citation statements)

References 35 publications

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“…FS, fibrin sealant; Co, control; Yueling Jiao, a commercial fibrin sealant made in China that is derived from pigs; NS, not stated; Y, yes; N, no. Study (Year) Cases (FS/Co) Mean Age (FS/Co) Male/Female (FS/Con) Doses Origin of FS Operation Methods Drainage DVT Prophylaxis Type of Prosthesis Lassen 15 33/36 67.1/63.1 12/21, 15/21 NS Autologous blood NS Y NS Cemented/ Cementless Falez 17 31/38 NS NS 10 mL Quixil lateral NS Enoxaparin 4000 U Cementless Wang 13 38/43 66.9/67.8 22/16, 23/20 10 mL Omrixil anterior or lateral Y Warfarin 10 mg/day Cemented/Cementless McConnell 18 22/22 NS 5/17, 9/13 10 mL Quixil NS N Aspirin 150 mg Cemented Mawatari 14 50/50 60/60 100/0 10 mL Autologous blood lateral Y NO Cementless Randelli 19 21/21 NS NS 10 mL Quixil lateral Y Enoxaparin NS Cementless Ren 2011 20/20 75.1 14/26 5 mL Yueling Jiao lateral Y NS NS ...…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-analysis of the Topical Administration of Fibrin Sealant in Total Hip Arthroplasty

Zhao

Sun

et al. 2018

Sci Rep

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Patients who undergo total hip arthroplasty (THA) may experience a large amount of blood loss. The objective of our study is to include randomized controlled trials (RCTs) and compare the clinical outcomes of fibrin sealant (FS) versus placebo after a THA. In October 2015, we searched the following databases: Medline, Embase, PubMed, the Cochrane Controlled Trials Register, Web of Science, the China National Knowledge Infrastructure, the China Wanfang database and Google Scholar. Finally, seven studies that included 679 patients met the inclusion criteria. The meta-analysis indicated that the topical administration of FS was associated with a reduction of the need for transfusion compared to the control group (P = 0.05). And topical FS will reduce total blood loss after THA (P = 0.0003) and blood loss in drainage (P = 0.002). However, there was no significant difference in terms of the intraoperative blood loss (P = 0.62) and the rate of deep venous thrombosis (DVT), fever, pain, anemia, hematoma and oozing. In conclusion, the use of FS in patients who are undergoing THA may reduce perioperative blood loss and attenuate the decrease in Hb. Furthermore, FS do not decrease the intraoperative blood loss without an increase in the risk of postoperative DVT, fever, pain, anemia, hematoma and oozing.

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Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-analysis of the Topical Administration of Fibrin Sealant in Total Hip Arthroplasty

Zhao

Sun

et al. 2018

Sci Rep

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“…Thus, if more restrictive transfusion strategies had been used in the present study, some of the patients in both groups might not have needed the transfusions following THA. In addition, new cost-effective blood management tools, such as tranexamic acid or fibrin sealant, could be a promising approach to reduce bleeding and consequently lead to lower transfusion rates after total joint arthroplasty in these patient populations [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of total hip arthroplasty in patients with primary immune thrombocytopenia

Lim

Yeo

Park

et al. 2015

BMC Musculoskelet Disord

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BackgroundImmune thrombocytopenia (ITP) is an immune-mediated acquired disease that is characterized by a decrease in the platelet count and an increased risk of bleeding. There is little information in the literature about the results of major joint replacement surgery in patients with ITP. The aim of this study was to report on the results of total hip arthroplasty (THA) in patients with primary ITP.MethodsWe retrospectively identified 15 THAs performed in 11 patients with primary ITP. The study group was matched (1:2) to a non-ITP control group of 30 THAs in 22 patients. According to the perioperative hematologic evaluation, blood management interventions were performed. All procedures were performed by a single surgeon and all patients received cementless components with ceramic-on-ceramic bearing. Mean duration of follow-up was 7.1 years (range, 2–13).ResultsNo significant differences were found between the two groups with regard to mean operative time, intraoperative blood loss, amount of closed suction drainage, length of hospital stay, and readmission rate. However, the proportion of patients requiring transfusion of packed red blood cells and/or platelet concentrate was higher in the ITP group when compared to the non-ITP group. Mean Harris hip score improved from 49.5 points preoperatively to 93.4 points at the final follow-up and no hips were revised for loosening or osteolysis in the ITP group. No significant differences were found between the two groups with respect to mean postoperative Harris hip scores and complication rates.ConclusionsOur study showed encouraging clinical and radiographic results of THA in patients with ITP without increased risk of adverse events compared to those in patients without ITP. On the basis of these findings, we suggest that modern cementless THA might be a viable treatment for achieving functional improvement in patients with ITP and end-stage hip disease.

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“…Several hemostasis strategies have been used to reduce blood loss in THA including topical and intravenous administration tranexamic acid, fibrin sealant, bipolar sealer, or electrocautery. 5 – 8 However, compared with electrocautery, a new blood loss device, bipolar sealer, which provided hemostasis at lower temperature (<100 °C) and thus, can decrease severe burns, severe tissue necrosis, and operating room fires. Since the bipolar sealer delivers radiofrequency energy to saline for hemostatic sealing and coagulation of soft tissue, and is currently utilized in total knee replacement, total hip arthroplasty, and hepatic transplantations.…”

Section: Introductionmentioning

confidence: 99%

The Efficacy of Bipolar Sealer on Blood Loss in Primary Total Hip Arthroplasty

Min

Zhang

et al. 2016

Medicine

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The blood loss during total hip arthroplasty is difficult to manage and there is no consensus about the effect of bipolar sealer used during operation. Thus, a systematic review of randomized controlled trials (RCTs) was performed to evaluate the efficacy and safety of blood loss using bipolar sealer after total hip arthroplasty (THA).Relevant literature of comparisons of bipolar sealer after THA for blood loss were searched for in Embase, PubMed, Web of Science, the Cochrane Central Register of Controlled Trials, and Google scholar from their inception to October, 2015. High-quality RCTs were selected to evaluate the need for transfusion, blood loss, and other complications. The software RevMan 5.30 was used for the meta-analysis.Six studies reporting on 6 RCTs comprising 751 patients were included. Compared with standard electrocautery, bipolar sealer was associated with lower rates of need for transfusion (relative risk [RR] = 0.60; 95% confidence interval [CI] 0.39–0.94), estimated blood loss (mean differences [MD] = −127.39; 95% CI −233.32 to −21.46; P = 0.02), and lower total blood loss (MD = −226.57; 95% CI −350.80–102.34; P = 0.0004). There is no significant difference between the hemoglobin drop, blood loss in drainage, intraoperative blood loss, Harris score, and rates of infection.The present meta-analysis indicated that bipolar sealer can decrease the need for transfusion and total blood loss; however, there is no benefit of bipolar sealer from the recovery. It is still need for samples to determine the balance between the economic cost and transfusion.

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Effectiveness of Fibrin Sealant after Cementless Total HIP Replacement: A Double-Blind Randomized Controlled Trial

Abstract: EudraCT 2008-002024-28.

Cited by 20 publications

References 35 publications

A Systematic Review and Meta-analysis of the Topical Administration of Fibrin Sealant in Total Hip Arthroplasty

A Systematic Review and Meta-analysis of the Topical Administration of Fibrin Sealant in Total Hip Arthroplasty

Outcomes of total hip arthroplasty in patients with primary immune thrombocytopenia

The Efficacy of Bipolar Sealer on Blood Loss in Primary Total Hip Arthroplasty

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