Tranexamic Acid - Major Antifibrinolytic Agent Used to Achieve Hemostasis in Hemophilic Patients with Anti-Factor VIII Anti-Bodies Who Must Undergo Total Joint Replecement

Abstract

Hemophilia is a congenital coagulopathy characterized by a deficiency of coagulation factor VIII or IX. The main complication of this hemopathy is represented by the hemorrhagiparous phenomena that affect mainly the musculoskeletal system. Of the various chronic complications of this condition, hemarthrosis is responsible for the onset of chronic arthropathy, which is a disabling condition. In addition to hematologist-prescribed coagulation factor replacement therapy, acute hemarthrosis and chronic arthropathy management requires close collaboration with both orthopedic surgeons and physiotherapists. This multidisciplinary collaboration is essential both to prevent the onset of hemarthroses and to manage acute bleeding episodes, to assess joint function and to effectively treat hemophilic chronic arthropathy. Hemophilic arthropathy causes significant joint instability and reduced mobility or even total ankylosis, which may lead to permanent disability and hence to a decrease in the patient�s quality of life. From an orthopedic point of view, disabling hemophilic arthropathy may be treated by surgery. Achieving effective hemostasis is vital in order to be able to perform these extremely difficult surgical procedures, due to the high risk of bleeding. This paper aims at highlighting the hemostatic efficacy of tranexamic acid in orthopedic surgery in hemophilic patients who must undergo total joint replacement.

Translation of nanotechnology-based implants for orthopedic applications: current barriers and future perspective

“…Metal, polymers, and bioceramics are currently the most commonly used materials in orthopedics ( Filip et al, 2019a ; Badulescu et al, 2019 ; Filip et al, 2019b ; Badulescu et al, 2020 ; Badulescu et al, 2021 ; Ma et al, 2021 ; Pattanayak and Sahoo, 2021 ; Tsakiris et al, 2021 ). Recent data indicate that biomedical nanotechnology is receiving increased attention ( Soni et al, 2018 ; Kalyanaraman et al, 2019 ; Li et al, 2020 ; Nikolova and Chavali, 2020 ).…”

Biomaterials in Orthopedic Devices: Current Issues and Future Perspectives

“…Currently, the materials widely used in orthopedics are metal, bioceramics, and polymers [103][104][105][106][107][108][109][110]. Recent data suggest that a special interest is being given to biomedical nanotechnology.…”

Current practices in haemophilic patients undergoing orthopedic surgery ‑ a systematic review

“…In this regard, the use of Moroctocog alfa (a 3rd generation recombinant coagulation factor VIII) in patients with type A haemophilia has proven its safety and effectiveness in orthopaedic surgery (12,13). For of haemophilia patients with inhibitors undergoing total knee replacement surgery, tranexamic acid used as anti-fibrinolytic agent, has been proven to be efficient in reducing hemorrhagipareous pheno mena (14). Holme and Tjønnfjord (15) reported the efficacy of Simoctocog alfa (a 4th generation recombinant FVIII produced in a human cell line without chemical modification or fusion with any other protein) delivered by continuous infusion for bleeding prophylaxis during arthroplasty in patients with haemophilia A.…”