The Journal of arthroplasty
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Randomized Controlled Trial
Combination of intravenous and topical application of tranexamic acid in primary total knee arthroplasty: a prospective randomized controlled trial.
This study was aimed to determine the efficacy and safety of combined intravenous (IV) and topical application of tranexamic acid (TXA) in unilateral total knee arthroplasty (TKA) compared with the IV-TXA. One hundred eight-four patients were enrolled. ⋯ The results revealed that compared with the 3g IV-TXA, adding 1.5g topical TXA to 1.5g IV-TXA in unilateral TKA can have the similar effectiveness in reducing transfusion rate and total blood loss without sacrificing safety. The most important is that by adding topical TXA, patients can gain a smaller maximum decline of hemoglobin (Hb), less drainage volume, less postoperative knee pain, less knee swelling, shorter length of hospital stays and higher short-term satisfaction.
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Randomized Controlled Trial
Intraoperative platelet-rich plasma does not improve outcomes of total knee arthroplasty.
This randomized controlled study was conducted to assess the effects of platelet-rich plasma (PRP) on outcomes of total knee arthroplasty (TKA). Forty patients who underwent unilateral TKA were evaluated prospectively; 20 received intraoperative PRP and 20 served as control subjects. ⋯ Additionally, no distinct clinical characteristics were found in patients who received intraoperative PRP. Therefore, we conclude that intraoperative PRP does not improve outcomes of TKA.
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Comparative Study
Computer navigation results in less severe flexion contracture following total knee arthroplasty.
We compared postoperative flexion contracture in navigated total knee arthroplasty (TKA) versus conventional TKA. Two groups (Group 1: conventional, Group 2: navigated) of 235 consecutive patients matched for age and gender were retrospectively compared. ⋯ There were a significantly larger proportion of outliers in the conventional group. Computer navigation results in less severe flexion contracture and less frequent flexion contracture of more than 5 degrees as compared to conventional techniques.