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Hemostatic matrix effects on blood loss after total knee arthroplasty: A randomized controlled trial

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Abstract

Background: Total knee arthroplasty (TKA) can result in major postoperative blood loss which can impact on the recovery and rehabilitation of patients. It also requires expensive transfusions. The purpose of the study was to investigate whether a hemostatic matrix, composed of cross-linked gelatin and a thrombin solution, would reduce blood loss in patients following TKA.

Materials and Methods: This was a prospective, randomized, controlled study (Trial registration: Hospital S. Salvatore LAquila ADJ00843) conducted in 93 patients. Criteria for participation were unilateral TKA for osteoarthritis, and a preoperative hemoglobin level >13 g/dL. The outcomes measured were postoperative hemoglobin and hematocrit levels measured at 24h, 72 h, and 7 days. The mean total postoperative blood loss was calculated from drainage volume, patient blood volume, hematocrit, and red blood cell volume. In addition, the drain output within 24 h following surgery and any transfusion requirements were determined.

Results: Hemostatic matrix-treated patients (n = 51) showed signifcant reductions in calculated postoperative blood loss of 32.3% and 28.7% versus control in men and women, respectively (P < 0.01). Postoperative blood loss after 24 h in drain was signifcantly less with the hemostatic matrix versus control, as were decreases in hemoglobin levels 7 days post-surgery (each P < 0.01). Three patients in the control group required blood transfusion, whereas no blood transfusions were necessary in the hemostatic matrix group.

Conclusion: The use of a hemostatic matrix provides a safe and effective means to reduce blood loss and blood transfusion requirements in TKA.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, San Salvatore Hospital, Via Vetoio, No. 1, 67100, L’Aquila, Italy

    Alexander Di Francesco, Stefano Flamini, Filippo Fiori & Franco Mastri

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  1. Alexander Di Francesco
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  2. Stefano Flamini
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  3. Filippo Fiori
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  4. Franco Mastri
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Correspondence to Alexander Di Francesco.

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Di Francesco, A., Flamini, S., Fiori, F. et al. Hemostatic matrix effects on blood loss after total knee arthroplasty: A randomized controlled trial. IJOO 47, 474–481 (2013). https://doi.org/10.4103/0019-5413.118203

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  • DOI: https://doi.org/10.4103/0019-5413.118203

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