Is blood transfusion really required in simultaneous bilateral Total Knee Replacement: A retrospective observational study

Vaish, Abhishek; Belbase, Rupesh Jung; Vaishya, Raju

doi:10.1016/j.jcot.2020.01.014

Cited by 8 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nearly half of the patients underwent simultaneous bilateral TKA, and no increase in complications was noted. Nevertheless, bilateral TKA tend to require more blood transfusion than unilateral TKA, in the revision performed by Vaish et al 20 32% of male patients without haemophilia who underwent bilateral TKA required blood transfusion. In this report, 17% of the patients required blood transfusion and all of them underwent bilateral TKA suggesting that the risk of requiring blood transfusion in this cohort is more related to surgery than to the clotting factor administration protocol.…”

Section: Discussionmentioning

confidence: 99%

Knee haemophilic arthropathy care in Chile: Midterm outcomes and complications after total knee arthroplasty

Oyarzun¹,

Barrientos

Barahona

et al. 2020

Haemophilia

View full text Add to dashboard Cite

Introduction: Total knee arthroplasty (TKA) can improve knee function in the general population, but challenges arise for TKA use in haemophilic patients (HPs). Aim: This study aimed to evaluate the midterm clinical experience of a single medical centre in TKA in HPs. Methods: We performed a case series of consecutive TKAs from 2007 to 2013 in HPs. All patients received coagulation factor supplementation according to the institutional protocol. Surgery was performed without a tourniquet by a standard midline medial parapatellar approach. We compared the range of motion (ROM) and flexion contracture before surgery and 1-year postoperative using paired Wilcoxon-nonparametric test (P < .05 was considered significant). The need for revision surgery was considered TKA survival failure. Results: Forty-one HP/60 TKAs were reviewed (19 cases were bilateral). Preoperative median ROM and flexion contracture was 75° (range, 0°-95°) and 20° (range, 5°-80°), respectively. The postoperative median ROM increased to 83° (range, 45°-110°), and median flexion contracture decrease to 0° (range, 0°-40°) a statistically significant difference (P < .01). Postoperative median clinical Knee Society Score (KSS) and functional KSS were 88 (range, 59-97) and 100 (range, 30-100), respectively. Six patients required revision (6.66%) due to infection. TKA survival at 5 years was 92% (range, 82%-96%). Conclusion: This study supports that TKA improves function and ROM in haemophilic knee arthropathy. The protocol of coagulation factors used in this cohort is valid as no related complications were reported. A higher incidence of complications, especially infections, must be expected compared with a TKA in non-HPs. K E Y W O R D S haemophilic knee arthropathy, simultaneous bilateral TKA, TKA complications, TKA survival, total knee arthroplasty e180 | OYARZUN et Al. How to cite this article: Oyarzun A, Barrientos C, Barahona M, et al. Knee haemophilic arthropathy care in Chile: Midterm outcomes and complications after total knee arthroplasty.

show abstract

Section: Discussionmentioning

confidence: 99%

Knee haemophilic arthropathy care in Chile: Midterm outcomes and complications after total knee arthroplasty

Oyarzun¹,

Barrientos

Barahona

et al. 2020

Haemophilia

View full text Add to dashboard Cite

show abstract

“…Anemia can be corrected by blood transfusion, which has been shown to effectively reduce postoperative complications. Some studies [29,30] have suggested that patients with Hb levels < 80.0 g/L should receive blood transfusions. However, Smeets et al suggested that allogeneic transfusions may increase long-term mortality and cardiovascular events in patients after hip fracture surgery.…”

Section: Discussionmentioning

confidence: 99%

Association of hemoglobin levels at admission with postoperative pneumonia in elderly patients with hip fracture: A retrospective cohort study

Zhang

Sun

et al. 2023

Medicine

View full text Add to dashboard Cite

Previous studies have suggested a correlation between low preoperative hemoglobin (Hb) levels and postoperative pneumonia (POP) in elderly patients with hip fractures. However, the exact inflection point of Hb level that increases the risk of POP remains unclear. This study aimed to investigate the quantitative relationship between preoperative Hb levels and the incidence of POP in this patient population. This retrospective study included 1417 elderly patients with hip fractures who were admitted to the Department of Orthopedics at Shenzhen Second People’s Hospital between January 2012 and December 2021. Demographic and clinical data, including laboratory test results, were analyzed and compared to explore the relationship between Hb levels at admission and the incidence of POP in this patient population. This study included 1417 elderly patients with hip fractures, comprising 382 males and 1035 females, with a mean age of 77.57 ± 8.73 years. The incidence of POP was 6.21% (88/1417) in this patient population. After adjusting for confounding factors in model II, the regression equation showed that the incidence of POP decreased by 2% with each 1 g/L increment in Hb levels (OR: 0.98, 95% CI: 0.97–1.00; P = .0211). Additionally, a two-piecewise regression model was used to explore the relationship between Hb levels and POP incidence, after adjusting for confounding factors. Threshold effect analysis showed that the inflection point was 83.5 g/L. On the left side of the inflection point, Hb levels were negatively correlated with the incidence of POP (OR: 0.91, 95% CI: 0.86–0.97, P = .0030). There was a nonlinear relationship between preoperative Hb level and POP in elderly patients with hip fractures. When Hb levels were lower than 83.5 g/L, preoperative Hb levels were negatively correlated with POP.

show abstract

“…In contrast, the transfusion rate for staged bilateral TKA (SBTKA) remains relatively high. Even with the implementation of PBM strategies, the transfusion rate after SBTKA ranges from 34.7% [19] to up to 96.5% [20]. This highlights the need for a new strategy to lower the transfusion rate after SBTKA.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Robotic Arm-Assisted Total Knee Arthroplasty on Transfusion Rate in Staged Bilateral Surgery

Lee

Jung

Choi

et al. 2023

JCM

View full text Add to dashboard Cite

The transfusion rate in staged bilateral total knee arthroplasty (TKA) remains high despite the application of blood management techniques. The potential of robotic arm-assisted TKA (R-TKA) in reducing the transfusion rate in staged bilateral surgery has not yet been investigated. Therefore, we aimed to evaluate the effectiveness of R-TKA on transfusion reduction compared with conventional TKA (C-TKA) in staged bilateral surgery. This retrospective study involved two groups of patients who underwent 1-week interval staged bilateral TKA—the C-TKA group and the R-TKA group—using MAKO SmartRobotics (Stryker, Kalamazoo, MI, USA). Each group comprised 53 patients after propensity score matching and was compared in terms of nadir hemoglobin (Hb) level and transfusion rate after each stage of surgery. Both groups showed no significant differences in the propensity-matched variables of age, sex, body mass index, American Society of Anesthesiologists physical status score, and preoperative Hb level. The R-TKA group showed a significantly higher nadir Hb level than the C-TKA group after the second TKA (p = 0.002). The transfusion rate was not significantly different between the two groups after the first TKA (p = 0.558). However, the R-TKA group showed a significantly lower transfusion rate in the TKA (p = 0.030) and overall period (p = 0.023) than the C-TKA group. Patients who undergo staged bilateral R-TKA have lower transfusion rate than those who undergo C-TKA. R-TKA may be effective in minimizing unnecessary allogeneic transfusions in staged bilateral surgery.

show abstract

Is blood transfusion really required in simultaneous bilateral Total Knee Replacement: A retrospective observational study

Cited by 8 publications

References 12 publications

Knee haemophilic arthropathy care in Chile: Midterm outcomes and complications after total knee arthroplasty

Knee haemophilic arthropathy care in Chile: Midterm outcomes and complications after total knee arthroplasty

Association of hemoglobin levels at admission with postoperative pneumonia in elderly patients with hip fracture: A retrospective cohort study

Effectiveness of Robotic Arm-Assisted Total Knee Arthroplasty on Transfusion Rate in Staged Bilateral Surgery

Contact Info

Product

Resources

About