Abstract:
:Perioperative blood loss after total knee arthroplasty (TKA) affects postoperative recovery. Tranexamic acid is safe and efficient in reducing blood loss without increasing thromboembolic events. Epsilon-aminocaproic acid (ε-ACA) is less expensive than and as safe as tranexamic acid. Its efficiency when locally applied in TKA is unknown. The authors retrospectively followed 240 consecutive patients treated by 1 surgeon with TKA from January 2012 to August 2016. From January 2013 to May 2015, the authors topically applied 5 g of ε-ACA to the open wound after tourniquet release and before closure (ε-ACA-after-tourniquet-release group). From August 2015 to August 2016, the authors topically applied 5 g of ε-ACA intraoperatively to the open wound 3 minutes before tourniquet release (ε-ACA-before-tourniquet-release group). The last 80 patients not receiving ε-ACA (control group), the 80 patients in the ε-ACA-after-tourniquet-release group, and the 80 patients in the ε-ACA-before-tourniquet-release group were compared regarding blood loss, treatment costs, and thromboembolic complications. The mean±SD calculated blood loss was 1478.8±367.1 mL for the control group, 1424.0±249.3 mL for the ε-ACA-after-tourniquet-release group, and 1052.3±419.1 mL for the ε-ACA-before-tourniquet-release group (P<.05). Using ε-ACA before tourniquet release reduced the length of hospital stay by 0.7 days (P<.05) compared with not using ε-ACA, leading to cost savings of $1547.37 per patient. One patient in the ε-ACA-before-tourniquet-release group and 1 patient in the control group developed a venous thromboembolism in the postoperative period. Epsilon-aminocaproic acid significantly reduces blood loss after TKA when topically applied before tourniquet release. Its application reduced costs by decreasing the length of hospital stay and did not increase thromboembolic events. [Orthopedics. 2017; 40(6):e1044-e1049.].
journal_name
Orthopedicsjournal_title
Orthopedicsauthors
Harper RA,Sucher MG,Giordani M,Nedopil AJdoi
10.3928/01477447-20170925-07subject
Has Abstractpub_date
2017-11-01 00:00:00pages
e1044-e1049issue
6eissn
0147-7447issn
1938-2367journal_volume
40pub_type
杂志文章相关文献
ORTHOPEDICS文献大全abstract::ABSTRACTA prospective, randomized, double-blind trial was performed in total hip replacement patients to document the risk of deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving enoxaparin 40 mg/day during hospita...
journal_title:Orthopedics
pub_type: 社论
doi:10.3928/0147-7447-19970202-08
更新日期:1997-02-01 00:00:00
abstract::Despite significant research documenting the detrimental effects of tobacco, the orthopedic literature lacks evidence regarding how surgeons alter their management of elective surgery when patients use nicotine. To better understand how patients' use of nicotine influences orthopedic surgeons' pre- and postoperative m...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20160901-02
更新日期:2017-01-01 00:00:00
abstract::The purpose of this study was to determine if the use of screw hole inserts in empty locking screw holes improves the strength and failure characteristics of locking plates. Twenty 5-hole 1/3 tubular locking plates (Synthes, Paoli, Pennsylvania) were mounted on an oak dowel with a 1-cm gap simulating a fracture with c...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20101123-13
更新日期:2011-01-03 00:00:00
abstract::One hundred ninety-seven consecutive primary cemented total hip arthroplasties using 22 mm heads were evaluated for the rate of dislocation. All surgery was performed by one surgeon through a posterior approach. A Charnley type femoral component was used in each case. Patients were divided into three groups based on t...
journal_title:Orthopedics
pub_type: 杂志文章
doi:
更新日期:1993-08-01 00:00:00
abstract::Carpal tunnel syndrome (CTS) is the most common peripheral entrapment neuropathy. Its diagnosis is based on clinical symptoms and neurophysiological evaluation. Recently, ultrasonography has been introduced as a promising noninvasive diagnostic alternative. In this study, the authors compared ultrasonography with neur...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20190604-02
更新日期:2019-09-01 00:00:00
abstract::Total hip arthroplasty (THA) infection imposes a significant burden on the patient and the health care system. Two-stage revision with interval placement of an antibiotic-cement spacer is the standard of care for chronic periprosthetic infections. This treatment allows for the direct delivery of antibiotics to the inf...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20100722-21
更新日期:2010-09-07 00:00:00
abstract::Eighteen consecutive patients with posterior cruciate ligament injury and associated pathology were reviewed. All were re-examined with an average follow up of 5.4 years (range: 3.5 to 7.5). Six posterior cruciate ligaments were repaired to the femur with multiple #2 nonabsorbable suture, and one "mop end" mid-substan...
journal_title:Orthopedics
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::Dislocation of the peroneal tendons associated with calcaneus fractures should be repaired during fracture fixation to prevent complications. The only documented approach for repair is by proximal extension of the vertical limb of the lateral extensile approach to the calcaneus. However, enlarging the inherently fragi...
journal_title:Orthopedics
pub_type: 临床试验,杂志文章
doi:10.3928/01477447-20140124-05
更新日期:2014-02-01 00:00:00
abstract::Carpal tunnel syndrome usually presents bilaterally and space-occupying lesions should be suspected in patients with unilateral symptoms, especially with a long history and when the symptomatic hand shows severe neurophysiologic impairment, while the contralateral hand is neurophysiologically intact. Approximately hal...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20090818-20
更新日期:2009-10-01 00:00:00
abstract::Tibial stems are necessary in most total knee revisions to share the load and protect the fixation interface of the tibial tray. Successful use of a tibial stem requires independent stability of the stem with or without cement. Some additional geometry on the undersurface of the tibial tray such as peripheral pegs or ...
journal_title:Orthopedics
pub_type: 评论,杂志文章
doi:
更新日期:2004-09-01 00:00:00
abstract::Disruption of the femoral head contour by collapse of necrotic segments is considered to be an important turning point in the history of avascular necrosis of the femoral head, and in many cases, surgical treatment is required soon after the onset of symptoms. However, in a few cases, conservative treatment is suffici...
journal_title:Orthopedics
pub_type: 临床试验,杂志文章
doi:
更新日期:2008-08-01 00:00:00
abstract::This study presents a consecutive series of patients who underwent total knee arthroplasty (TKA) after prior distal femoral fracture without hardware removal. The purpose of this study was to determine the effectiveness of computer-assisted TKA in patients with posttraumatic arthritis, specifically those with retained...
journal_title:Orthopedics
pub_type: 临床试验,杂志文章
doi:10.3928/01477447-20120919-55
更新日期:2012-10-01 00:00:00
abstract::Unicompartmental arthroplasty results and survivorship will continue to improve with time. The future will refine patient selection and bring better surgical techniques and prosthetic designs. Improved polyethylene will increase longevity of the arthroplasty, and mobile-bearing articulations also may improve longevity...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20060901-36
更新日期:2006-09-01 00:00:00
abstract::Partial weight bearing is often prescribed for patients with orthopedic injuries. Patients’ ability to accurately reproduce partial weight bearing orders is variable, and its impact on clinical outcomes is unknown. This observational study measured patients’ ability to reproduce partial weight bearing orders, factors ...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20131219-10
更新日期:2014-01-01 00:00:00
abstract::A case of a 14-year-old male with a history, physical exam, and x-rays compatible with an epiphyseal injury of the proximal right clavicle is presented. Typical symptoms, physical examination findings, and special roentgenographic views are discussed along with conservative and operative modes of treatment. ...
journal_title:Orthopedics
pub_type: 社论
doi:10.3928/0147-7447-19820501-11
更新日期:1982-05-01 00:00:00
abstract::Multiligamentous knee injuries with simultaneous patellar tendon ruptures are rare. Surgeons must be prepared to address injured structures of the knee to allow return of knee function. Restoring motion while protecting repairs is important. The authors present 2 cases and discuss treatment strategy for preoperative e...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20150105-06
更新日期:2015-01-01 00:00:00
abstract::Distal tibiofibular syndesmosis injuries are complex injuries that often result in extended loss of playing time for athletes. Unstable syndesmosis injuries are uniformly reduced and stabilized by numerous methods. Controversy arises from syndesmosis injuries that are stable on stress radiographs but functionally unst...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20130222-07
更新日期:2013-03-01 00:00:00
abstract::This article presents the case of a 52-year-old man with a chronic anterior shoulder dislocation accompanied by a massive Hill-Sachs lesion. The dislocation occurred 6 weeks prior to presentation as the result of a seizure. At the time of the initial injury, the patient was treated in the emergency department and told...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20090101-15
更新日期:2009-01-01 00:00:00
abstract::Retrieved polyethylene liners and femoral heads from a consecutive series of revision components of one design were examined. All patients had Long-Term Stable Fixation (OsteoTechnology International, Timonium, Md) total hip arthroplasties (THAs) implanted between 1987 and 1992. The retrieved femoral heads and liners ...
journal_title:Orthopedics
pub_type: 杂志文章
doi:
更新日期:2002-12-01 00:00:00
abstract::A case of synovial sarcoma in a six year old boy is reported. A brief discussion of the tumor is also included. ...
journal_title:Orthopedics
pub_type: 社论
doi:10.3928/0147-7447-19790901-06
更新日期:1979-09-01 00:00:00
abstract::Numerous articles have been written about methods of closed biopsy of the spine. One of the most recent is by Moore et al,1 who describes his method as used at the Los Angeles General Hospital. The method described in this report is a simple and safe method for closed biopsy of the lumbar vertebra. ...
journal_title:Orthopedics
pub_type: 社论
doi:10.3928/0147-7447-19800401-06
更新日期:1980-04-01 00:00:00
abstract::The human medial cuneiform is incompletely characterized with regard to anatomical morphology, including mineral density and bone quality. Clinically, we have observed failures of fixation by pull-through of devices through relatively soft medial bone. Defining patterns of relative density may provide valuable informa...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20110317-07
更新日期:2011-05-18 00:00:00
abstract::The purpose of this study is to demonstrate that the percentage of obese individuals initially presenting to total joint arthroplasty clinics in a public, tertiary hospital is greater than the proportion of obese individuals in the general population. In a retrospective, comparative study of patients seen in total joi...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20151222-12
更新日期:2016-01-01 00:00:00
abstract::The activity of eight antimicrobial agents which might be used in the treatment of staphylococcal osteomyelitis was tested under anaerobic conditions similar to those found in chronically infected bone. An agar-dilution method was employed to determine the minimum inhibitory concentrations of tobramycin, vancomycin, t...
journal_title:Orthopedics
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::Isolated injuries of the posterolateral corner of the knee are uncommon injuries in adults and are relatively unheard of in the pediatric population. This article reports a case of a 13-year-old boy who sustained an external rotation injury to his proximal tibia on a slightly flexed knee while playing football. Radiog...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20110826-22
更新日期:2011-10-01 00:00:00
abstract::Infantile tibia vara (infantile Blount's disease) is a condition in which progressive varus of the knee develops due to diminished physeal growth of the medial aspect of the proximal tibia. A 6-year-old boy with severe bilateral infantile tibia vara (Langenskiold stage V) underwent operative correction of his deformit...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20080501-10
更新日期:2008-05-01 00:00:00
abstract::Anterior cruciate ligament (ACL) tears are commonly seen injuries. Initially, these injuries are routinely evaluated with radiographs, followed by magnetic resonance imaging (MRI). The altered kinematics at the time of injury or for the duration of a chronic tear can create indirect findings on radiographs and MRI. Th...
journal_title:Orthopedics
pub_type: 杂志文章
doi:10.3928/01477447-20141023-06
更新日期:2014-11-01 00:00:00
abstract::Pulsed low-energy ultrasound, a non-invasive therapeutic treatment modality, may improve callus formation and enhance fracture healing by initiating enhanced angioneogenesis. ...
journal_title:Orthopedics
pub_type: 杂志文章,评审
doi:
更新日期:2005-10-01 00:00:00
abstract::A new frame has been designed to maintain patients in what the author chooses to call the prone sitting position during back surgery. Studies have shown such a position to be far superior to other positions in minimizing blood loss during surgical procedures on the back. The new frame has the advantages of accommodati...
journal_title:Orthopedics
pub_type: 社论
doi:10.3928/0147-7447-19790301-05
更新日期:1979-03-01 00:00:00
abstract::The incidence of musculoskeletal injury sustained during tobacco farming has been poorly documented. Using the trauma registry for all farm-related injuries occurring during a 16-month period, hospital charts, radiographs, and clinic charts were reviewed to identify those patients sustaining tobacco farming-related in...
journal_title:Orthopedics
pub_type: 杂志文章
doi:
更新日期:2000-02-01 00:00:00