Blood transfusions in total knee arthroplasty: a retrospective analysis of a multimodal patient blood management programme

Chan, PK; Hwang, YY; Cheung, Ankie Tan; Cheng, Yan; Fu, Henry; Chan, Timmy; Fung, Wing Chiu; Cheung, MH; Chan, Vincent Wk; Chiu, K. Y.

doi:10.12809/hkmj198289

Cited by 7 publications

(6 citation statements)

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“…36 Our local data showed that the transfusion rate was significantly reduced after the implementation of the patient blood management program with no difference in the readmission rate. 36…”

Section: Anemiamentioning

confidence: 71%

“…38,39 Finally, we employed a restrictive transfusion policy with a stringent transfusion trigger and a single unit transfusion. 36 Our local data showed that the transfusion rate was significantly reduced after the implementation of the patient blood management program with no difference in the readmission rate. 36…”

Section: Anemiamentioning

confidence: 71%

“…35 We perform preoperative anemia screening and collaborate with the hematologist for further investigations and optimizations. 36 For instance, patients suffering from iron-deficiency anemia will have further workup for any gastrointestinal blood loss and given iron supplements to optimize their hemoglobin level before surgery. Combined intravenous and intra-articular tranexamic acid is routinely given to reduce intraoperative blood loss unless contraindicated, such as a history of cerebrovascular disease or transient ischemic attack, ischemic heart disease, acquired on congenital coagulopathy or prior thromboembolic disease.…”

Section: Anemiamentioning

confidence: 99%

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Preoperative optimization to prevent periprosthetic joint infection in at-risk patients

Chan

et al. 2020

J Orthop Surg (Hong Kong)

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Periprosthetic joint infection (PJI) remains an important complication with devastating consequences after total joint arthroplasties. With the increasing number of arthroplasties worldwide, the number of PJI will increase correspondingly with a significant economic burden to our healthcare system. It is likely impossible to completely eradicate PJI; hence, assessment and optimization of its risk factors to preventing such a disastrous complication will be the key. There are many strategies to prevent PJI in the preoperative, intraoperative, or postoperative phases. The preoperative assessment provides a unique opportunity to screen and diagnose underlying comorbidities and optimize modifiable risk factors before elective surgeries. In this review, we will focus on current literature in preoperative assessment of various modifiable risk factors and share the experience and practical approach in our institution in preoperative optimization to reduce PJI in total joint arthroplasties.

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Section: Anemiamentioning

confidence: 71%

Section: Anemiamentioning

confidence: 71%

Section: Anemiamentioning

confidence: 99%

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Preoperative optimization to prevent periprosthetic joint infection in at-risk patients

Chan

et al. 2020

J Orthop Surg (Hong Kong)

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“…Knee Peking Union Medical College HS [ 370 ] 2. Chinese People’s Liberation Army [ 539 ] Hong Kong Hong Kong Institutional Queen Mary HS [ 282 , 367 , 471 , 554 , 617 , 622 ] Japan Takatsuki (Hip) Takatsuki General HS [ 359 ] Korea Korea Korean Hip (KHR) [ 489 ] Republic of China Taiwan Chang Gung Memorial HS [ 83 , 422 , 475 , 557 ] Singapore Singapore Singapore General HS [ 108 , 124 , 168 , 192 , 227 , 229 , 245 , 253 , 273 , 277 , 284 , 434 , 436 , 440 , 443 , 466 , 467 , 513 , 538 , 546 , 579 , 591 , 595 , 602 , 608 , 612 , 616 , 621 , ...…”

Section: Resultsmentioning

confidence: 99%

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Zgouridou,

Kenanidis,

Potoupnis

et al. 2023

Eur J Orthop Surg Traumatol

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Purpose Four joint arthroplasty registries (JARs) levels exist based on the recorded data type. Level I JARs are national registries that record primary data. Hospital or institutional JARs (Level II–IV) document further data (patient-reported outcomes, demographic, radiographic). A worldwide list of Level II–IV JARs must be created to effectively assess and categorize these data. Methods Our study is a systematic scoping review that followed the PRISMA guidelines and included 648 studies. Based on their publications, the study aimed to map the existing Level II–IV JARs worldwide. The secondary aim was to record their lifetime, publications’ number and frequency and recognise differences with national JARs. Results One hundred five Level II–IV JARs were identified. Forty-eight hospital-based, 45 institutional, and 12 regional JARs. Fifty JARs were found in America, 39 in Europe, nine in Asia, six in Oceania and one in Africa. They have published 485 cohorts, 91 case-series, 49 case–control, nine cross-sectional studies, eight registry protocols and six randomized trials. Most cohort studies were retrospective. Twenty-three per cent of papers studied patient-reported outcomes, 21.45% surgical complications, 13.73% postoperative clinical and 5.25% radiographic outcomes, and 11.88% were survival analyses. Forty-four JARs have published only one paper. Level I JARs primarily publish implant revision risk annual reports, while Level IV JARs collect comprehensive data to conduct retrospective cohort studies. Conclusions This is the first study mapping all Level II–IV JARs worldwide. Most JARs are found in Europe and America, reporting on retrospective cohorts, but only a few report on studies systematically.

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“…It is expected that about 1.4 to 1.8 ltr blood can be lost during a joint replacement surgery. The rate of blood transfusion can be as high as 30 % (1). As majority of the patients are elderly and often associated with co morbid conditions, post-operative anemia can increase the risk of cardiopulmonary events as well as health care costs.…”

Section: Introductionmentioning

confidence: 99%

Retrospective Study on transfusion requirements and deep vein thrombosis incidence with the use of Tranexamic acid on total knee replacement

Rana¹,

Lakhey²,

Jha³

et al. 2022

Nep. Mediciti Med. J.

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BACKGROUND Total knee replacement is often associated with significant blood loss and increased rate of blood transfusion. Tranexamic acid is a potent anti-fibrinolytic agent and its use in major surgeries has shown to decrease blood loss as well as transfusion rates. It is used intravenous, oral and topical forms as well. This study aims to find out the effectiveness of systemic Tranexamic acid in terms of decrease in transfusion rate as well incidence of deep vein thrombosis (DVT) and thromboembolism. MATERIALS AND METHODS Total number of patients were 94 of which 58 had bilateral knees replacement and 36 patient underwent unilateral knee replacement over the period of 3 years (December 2018 –December 2021). All patients were screened for general condition as well as any coagulopathy pre –op. All patients were given IV form of Tranexamic acid followed by oral form for 3 days post operatively. Tourniquet was used in all cases and low molecular weight heparin (Clexane) 40 mg subcutaneous once a day for 1-2 days followed by oral aspirin was given for 6 weeks to all patients. SCD calf pumps were used for 4 to 5 days. RESULTS We found that incidence of blood transfusion was only 6.9% in our case series which was well within the incidence reported in varied literature on the use of Tranexamic acid in knee replacement surgery. There was no clinical feature of deep vein thrombosis / pulmonary embolism (DVT/PE) in any of our patients. CONCLUSION Use of Tranexamic acid is a safe and effective method for controlling blood loss and decreasing the transfusion rate after total knee replacement surgery. Its intravenous and oral forms are readily available and cost effective. Its use is not associated with DVT or PE.

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Blood transfusions in total knee arthroplasty: a retrospective analysis of a multimodal patient blood management programme

Cited by 7 publications

References 0 publications

Preoperative optimization to prevent periprosthetic joint infection in at-risk patients

Preoperative optimization to prevent periprosthetic joint infection in at-risk patients

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Retrospective Study on transfusion requirements and deep vein thrombosis incidence with the use of Tranexamic acid on total knee replacement

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