Tranexamic acid is associated with selective increase in inflammatory markers following total knee arthroplasty (TKA): a pilot study

Tranexamic acid (TXA) is commonly used in orthopedic surgery to reduce excessive bleeding and transfusion requirements. Our aim was to examine if TXA was required in all osteoarthritis patients undergoing TKA ...
Source: Journal of Orthopaedic Surgery and Research - Category: Orthopaedics Authors: Tags: Research article Source Type: research

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DiscussionConsidering that the hip joint capsule is innervated by proprioceptive nerve endings, while the psuedocapsule that replaces the native capsule following a THA with capsulectomy doesn't have any active neurophysiological role, we hypothesize that capsulotomy with capsular conservation at the time of primary THA may lead to better proprioception and therefore better functional recovery.Trial identifier: NCT02749058. Date of registration: 04/21/2016;
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research
Conclusion: The combined use of IAI and PAI of TXA can significantly reduce the TBL and the need for blood transfusion without delaying wound healing or increasing the risk of DVT and PE. In the short-term after surgery, this combined method reduces the pain VAS scores and improves the ROM; however, there are no long-term effects on VAS and ROM.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Trial/Experimental Study Source Type: research
Publication date: Available online 30 May 2019Source: American Journal of Infection ControlAuthor(s): Claas Baier, Simon Adelmund, Frank Schwab, Christoph Lassahn, Iris Freya Chaberny, Frank Gossé, Ralf-Peter Vonberg, Ella EbadiKnee arthroplasty is commonly performed in the case of advanced osteoarthritis, and deep joint infections represent a severe complication following surgery. A 4-year retrospective cohort study was conducted to determine the incidence and risk factors for such surgical site infections. Of the 2439 patients included in the study, 84 of them (3.4%) developed infections. Postoperative bleeding, A...
Source: American Journal of Infection Control - Category: Infectious Diseases Source Type: research
The concept of replication in research is widely accepted in most discipline (1); however, there is no consensus about when the evidence is sufficient to confidently state that a treatment works. One good example is a study by Fergusson et al. in 2005 who published a cumulative meta-analysis of the efficacy of Aprotinin to stop bleeding in cardiac surgery (2). They found that the estimates for its effectiveness were consistent after the first 12 studies; nevertheless, an additional 52 similar RCTs were carried out afterwards including more than 5,000 patients.
Source: Osteoarthritis and Cartilage - Category: Rheumatology Authors: Tags: Editorial Source Type: research
CONCLUSIONS: New oral anticoagulants were associated with a lower risk of symptomatic DVT and symptomatic PE in this large, registry study, and we observed no differences in the risk of bleeding, reoperation, or death between the groups. Although we were able to control for a number of potential confounding variables, we cannot ascertain the indications that drove the prescription decisions in this setting, and there were important between-group differences in terms of duration of thromboprophylaxis (new oral anticoagulants generally were used for a longer period of time after surgery). Future studies, preferably large ran...
Source: Clinical Orthopaedics and Related Research - Category: Orthopaedics Authors: Tags: Clin Orthop Relat Res Source Type: research
CONCLUSIONS: Moderate quality evidence indicates that compared to placebo, tramadol alone or in combination with acetaminophen probably has no important benefit on mean pain or function in people with osteoarthritis, although slightly more people in the tramadol group report an important improvement (defined as 20% or more). Moderate quality evidence shows that adverse events probably cause substantially more participants to stop taking tramadol. The increase in serious adverse events with tramadol is less certain, due to the small number of events. PMID: 31132298 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
CONCLUSIONS The administration of tranexamic acid in two IV doses of 10-15 mg/kg to patients with total knee and hip arthroplasty has proven to be efficient. A higher efficacy of TXA was reported in TKA and due to routine administration of TXA the postoperative autotransfusion system (ORTHO P.A.S.) ceased to be used in knee replacement surgery. Key words:total hip arthroplasty, total knee arthroplasty, tranexamic acid, blood loss, allogeneic transfusion, autotransfusion, postoperative complications. PMID: 31070570 [PubMed - in process]
Source: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca - Category: Orthopaedics Tags: Acta Chir Orthop Traumatol Cech Source Type: research
We examined the association between short (1-5 days), standard (6-14 days), and extended (≥ 15 days) duration of thromboprophylaxis, with regards to the risk of venous thromboembolism (VTE), major bleeding, and death in unselected THA patients. Patients and methods - We performed a cohort study using prospectively collected data from the population-based hip arthroplasty registries, prescription databases, and patient administrative registries in Denmark and Norway. We included 55,540 primary THA patients with osteoarthritis Results - The 90-day cumulative incidence of VTE was 1.0% for patients with standard treatment (...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Orthop Source Type: research
Authors: Rutlen C, Rutlen DL Abstract With the increase in participation in endurance events in the general population, patient concern may arise as to whether endurance exercise is safe. Acute but not chronic increases in blood urea nitrogen, creatinine, and urine albumin occur in endurance exercise. Iron-deficiency anemia may be observed in female athletes. Upper respiratory illness is increased in elite athletes but decreased in intense recreational athletes. No convincing evidence of developing osteoarthritis exists. Common gastrointestinal symptoms occur and isolated reports of gastrointestinal bleeding exist....
Source: Southern Medical Journal - Category: General Medicine Tags: South Med J Source Type: research
ConclusionsArthroscopic release for the severely stiff elbow could improve range of motion. Careful attention should be given during surgery to avoid complications such as intramuscular bleeding or nerve damage.
Source: Musculoskeletal Surgery - Category: Orthopaedics Source Type: research
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