Rivaroxaban improves hidden blood loss, blood transfusion rate and reduces swelling of the knee joint in knee osteoarthritis patients after total knee replacement

Abstract

Osteoarthritis (OA) is the third most common diagnosis made by general practitioners in older patients. The purpose of the current study is to investigate effects rivaroxaban had on both hidden blood loss and blood transfusion rate (BTR) in patients with knee OA (KOA) after going through a total knee replacement (TKR).Between the time periods of December 2011 up until January 2015, a total of 235 patients underwent TKR and were selected to be assigned to either the rivaroxaban or nonanticoagulant groups. Coagulation function indexes before surgery and following administration of rivaroxaban, total blood loss, hidden blood loss, dominant blood loss, blood transfusion volume, hemoglobin reduction, degree of postoperative pain (visual analogue scale), the degree of knee swelling, and range of motion following surgery were all recorded. Hospital for special surgery (HSS) scores offered an objective evaluation for the knee joint functions before surgery at the intervals of 2 weeks and after surgery at intervals of 3 months, 6 months, 12 months, and 24 months.Patients in the rivaroxaban group had shown a higher hidden blood loss, as well as a higher BTR, compared to those involved in the nonanticoagulant group. BTR was found to have been 49.59% in the rivaroxaban group, and 35.09% for the nonanticoagulant group. Patients in the rivaroxaban group had lower degrees of knee swelling than those involved in the nonanticoagulant group. There was no deep vein thrombosis (DVT) detected in the rivaroxaban group, whereas 5 DVT cases were detected in the nonanticoagulant group. In the rivaroxaban group, the HSS scores of the knee joint functions were remarkably higher at the 2-week mark in succession to the surgery than those involved with the nonanticoagulant group.This overall data demonstrated that KOA patients after TKR had presented with a higher hidden blood loss, BRT, and lower swelling degrees of the knee joint after being treated by the rivaroxaban.

Application of General Anesthesia Combined with Saphenous Nerve-Tibial Nerve Block in Total Knee Arthroplasty

“…The SBP and MAP levels at T2, T3, and T4 and the HR levels at T3 and T4 were also significantly lower in patients treated with the combined selective tibial nerve plus saphenous nerve block compared with the group given single general anesthesia. The VAS is an important index commonly used in clinical practice to assess the degree of pain, and the higher the score, the more severe the pain [ 20 , 21 ]. Moreover, there was no significant difference in the incidence of adverse reactions between the two groups.…”

Pharmacotherapy for Venous Thromboprophylaxis following Total Hip or Knee Arthroplasty: A Systematic Review and Network Meta-analysis

“…Studies that excluded surgical-site bleeding from their definition of major bleeding reported major bleeding rates approximately 10 times lower than those studies that included it. In certain RCTs assessing rivaroxaban, 74,97,98,115,116 the definition of major bleeding did not encompass surgical-site bleeding. The majority of trials involving rivaroxaban and apixaban used the hemoglobin level on the first postoperative day as a baseline (to avoid the confounder of intraoperative blood loss) to identify significant drops in hemoglobin as indicative of major bleeding.…”