Antifibrinolytic therapy in complex spine surgery: a case-control study comparing aprotinin and tranexamic acid.

Abstract:

:A case-control study was performed to determine the impact of aprotinin or tranexamic acid use on reducing intraoperative blood loss and transfusion needs in complex spine surgery. Sixty-nine patients undergoing complex spine surgery received aprotinin or tranexamic acid. The aprotinin group contained 30 patients (8 men and 22 women) and the tranexamic acid group 39 patients (11 men and 28 women). The following variables were recorded: duration of surgery, number of levels fused, intraoperative and total blood loss, and number of blood units transfused (autologous and allogenic). In addition, various parameters related to blood loss in this type of surgery were calculated. The groups differed with regard to duration of surgery (aprotinin 662 min vs tranexamic acid 448 min, P<.001) and number of levels fused (aprotinin 11.2 vs tranexamic acid 7.6, P=.004). There were no significant differences in intraoperative blood loss (aprotinin 2118 mL vs tranexamic acid 1608 mL, P=.066) or total blood loss (aprotinin 3312 mL vs tranexamic acid 2627 mL, P=.056). Statistical differences were found for the number of autologous blood units transfused (aprotinin 2.2 vs tranexamic acid 1.3 P=.047) and total units transfused (aprotinin 4.1 vs tranexamic acid 2.6, P=.008). Blood loss per hour of surgery, transfused units per level fused, and transfused units per hour of surgery were similar in the 2 groups. Significant differences were found for intraoperative blood loss per fusion level (aprotinin 228 mL vs tranexamic acid 428, P=.025) and total blood loss per fusion level (aprotinin 360 mL vs tranexamic acid 638 mL, P=.01). Analysis of the applied geometric mean showed that aprotinin reduced total blood loss by 16.4% and total number of blood units transfused by 12.4% as compared to tranexamic acid, although statistical significance was not reached. The type of antifibrinolytic used did not have a significant impact on the main outcome variables of the study.

journal_name

Orthopedics

journal_title

Orthopedics

authors

Colomina MJ,Bagó J,Vidal X,Mora L,Pellisé F

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

91

issue

2

eissn

0147-7447

issn

1938-2367

pii

orthopedics.35993

journal_volume

32

pub_type

杂志文章
  • The influence of sterilization method on wear performance of the low contact stress total knee system.

    abstract::Sterilization method changes to the Low Contact Stress (LCS) Total Knee System (DePuy Orthopaedics Inc, Warsaw, Ind) have resulted in progressive improvements in wear resistance. Initially, the system used the traditional gamma in air irradiation sterilization method, but was transitioned to Gas plasma sterilization. ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: McNulty DE,Liao YS,Haas BD

    更新日期:2002-02-01 00:00:00

  • Two-Stage Revision Anterior Cruciate Ligament Reconstruction.

    abstract::The number of primary anterior cruciate ligament (ACL) tears is rapidly increasing. In patients who wish to return to their preoperative level of function, specifically as it pertains to participation in sports, the gold standard of treatment following an ACL tear remains an anterior cruciate ligament (ACL) reconstruc...

    journal_title:Orthopedics

    pub_type: 杂志文章,评审

    doi:10.3928/01477447-20160324-01

    authors: Erickson BJ,Cvetanovich G,Waliullah K,Khair M,Smith P,Bach B Jr,Sherman S

    更新日期:2016-05-01 00:00:00

  • Long-term results of dorsally displaced distal radius fractures treated with the pi-plate: is hardware removal necessary?

    abstract::The purpose of this study was to evaluate the outcome of patients treated with open reduction and internal fixation (ORIF) using dorsal plates and screws (AO/ASIF pi-plate) for dorsally displaced fractures of the distal radius. Although extensor tendon rupture is a recognized complication of all distal radial fracture...

    journal_title:Orthopedics

    pub_type: 临床试验,杂志文章

    doi:10.3928/01477447-20110526-10

    authors: Tyllianakis ME,Panagopoulos AM,Saridis A

    更新日期:2011-07-07 00:00:00

  • Subdeltoid lipoma: a case with symptoms mimicking glenohumeral instability and subacromial impingement.

    abstract::Lipoma is the most frequently occurring benign soft tissue tumor in the shoulder and the axillary region in middle-aged and older persons, yet few such lipoma cases have been associated with clinical symptoms. A 38-year-old right-handed man presented with an enlarged feeling and a painful back-and-forth popping in his...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20100429-30

    authors: Ui M,Ogawa K

    更新日期:2010-06-09 00:00:00

  • Free vascularized fibular grafting for patients receiving postoperative corticosteroids.

    abstract::Free vascularized fibular grafting (FVFG) is an effective method to treat corticosteroid-induced osteonecrosis of the femoral head (ONFH). Some patients continued to receive maintenance doses of corticosteroids to treat the primary disease postoperatively. This study was performed to evaluate outcomes of FVFG for cort...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20140401-56

    authors: Ding H,Chen SB,Gao YS,Lin S,Zhang CQ

    更新日期:2014-04-01 00:00:00

  • A prospective analysis of Oxford phase 3 unicompartmental knee arthroplasty.

    abstract::We performed 560 minimally invasive unicompartmental knee arthroplasties in patients with osteoarthritis using the Oxford phase 3 prosthesis since January 2002. For the prospective analysis, clinical and radiographic assessments were carried out preoperatively and regularly followed after surgery. Ninety-five cases we...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Kim KT,Lee S,Park HS,Cho KH,Kim KS

    更新日期:2007-05-01 00:00:00

  • Tibial plateau fractures. A review of operative treatment using AO technique.

    abstract::In a retrospective review of 80 tibial plateau fractures, 28 fractures were treated nonoperatively with a variety of closed methods and 52 were treated with open reduction and internal fixation using AO technique. At an average follow up of 24 months, a satisfactory result was obtained in 87% of the operatively treate...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Savoie FH,Vander Griend RA,Ward EF,Hughes JL

    更新日期:1987-05-01 00:00:00

  • The risk of venous thromboembolism in the orthopedic patient: epidemiological and physiological data.

    abstract::Venous thromboembolism is responsible for 500,000 deaths annually in industrialized countries. It is probably the most common preventable cause of death in elective orthopedic surgery patients. Rates of deep vein thrombosis (DVT) and fatal pulmonary embolism (PE) in unprotected orthopedic patient populations are high....

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Paiement GD,Mendelsohn C

    更新日期:1997-02-01 00:00:00

  • Avoiding and managing complications of the Agility Total Ankle Replacement system.

    abstract::Intermediate clinical and radiographic results of the new generation of total ankle arthroplasties have been encouraging. Many of the devastating problems of earlier designs have been avoided, yet these newer implants are not without complications. Many problems can be avoided with careful preoperative planning and by...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20061001-03

    authors: Raikin SM,Myerson MS

    更新日期:2006-10-01 00:00:00

  • Clavicle fracture with thoracic penetration and hemopneumothorax but without neurovascular compromise.

    abstract::Clavicle fractures are rarely associated with more severe neurologic or vascular injuries. When these associated injuries are encountered, prompt recognition and treatment are paramount to optimize outcome. The majority of fractures that result in neurovascular compromise are from high-energy trauma; however, a high i...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20110826-31

    authors: Tjoumakaris FP,Matzon JL,Williams GR

    更新日期:2011-10-05 00:00:00

  • Fixation of multifragmentary patella fractures using a bilateral fixed-angle plate.

    abstract::This biomechanical study is the first to compare 3 fixation methods-bilateral fixed-angle plate, modified anterior tension wiring, and cannulated lag screws with anterior tension wiring-in multifragmentary distal patella fractures. A T-shaped 3-part fracture simulating a multifragmentary articular distal patella fract...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20131021-29

    authors: Thelen S,Betsch M,Schneppendahl J,Grassmann J,Hakimi M,Eichler C,Windolf J,Wild M

    更新日期:2013-11-01 00:00:00

  • Ultrasound for Infants at Risk for Developmental Dysplasia of the Hip.

    abstract::The best screening method for developmental dysplasia of the hip is controversial. Ultrasonography is sensitive, but cost-effectiveness may limit its use. This study assessed whether ultrasound screening would increase in effectiveness if targeted toward infants with established risk factors for developmental dysplasi...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20150804-61

    authors: LeBa TB,Carmichael KD,Patton AG,Morris RP,Swischuk LE

    更新日期:2015-08-01 00:00:00

  • The role of proximal femoral valgus osteotomy in Legg-Calvé-Perthes disease.

    abstract::Proximal femoral valgus osteotomy for Legg-Calvé-Perthes disease was evaluated at an average 5 years postoperatively in 31 consecutive patients. The indications for osteotomy were hinge abduction and pain. The Iowa hip scores at follow-up for 21 patients averaged 93 points. Combined clinical and radiographic review fo...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Raney EM,Grogan DP,Hurley ME,Ogden MJ

    更新日期:2002-05-01 00:00:00

  • Anterior C1-C2 screw fixation and bony fusion through an anterior retropharyngeal approach.

    abstract::We present a case that demonstrates an occasion where an alternative method of C1-C2 fusion may be used when a posterior approach limited to the atlantoaxial level is not desirable. A 22-year-old man presented with a symptomatic nonunited Brooks posterior atlantoaxial fusion following a chronically displaced type II o...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Vaccaro AR,Lehman AP,Ahlgren BD,Garfin SR

    更新日期:1999-12-01 00:00:00

  • Femoral fixation in primary total hip arthroplasty.

    abstract::We have presented the major advantages of using femoral components that have porous coating over the entire stemmed portion and have a cylindrical distal shape. The advantages of a stem with these design features also are reflected in the changing pattern of hip implant usage. A decade ago, the most frequently used po...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Engh CA Sr,Culpepper WJ 2nd

    更新日期:1997-09-01 00:00:00

  • Fracture of polyethylene tibial component in a total knee replacement. A case report.

    abstract::Aseptic loosening is the most common mode of failure for total knee replacements. Component breakage is rare, usually attributable to errors of design or manufacture. A case is presented in which rotational malplacement of the femoral component resulted in accelerated wear and eventual fracture of the polyethylene tib...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Mowery C,Botte M,Bradley G

    更新日期:1987-02-01 00:00:00

  • Thoracoscopic sympathectomy in the management of vasomotor disturbances and complex regional pain syndrome of the hand.

    abstract::Complex regional pain syndrome, vasospastic disorders, and hyperhidrosis are chronic and debilitating upper extremity problems. Twenty-nine consecutive patients treated with thoracoscopic sympathectomy are presented. Diagnoses included complex regional pain syndrome, hyperhidrosis, Buerger's disease, Raynaud's disease...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Rizzo M,Balderson SS,Harpole DH,Levin LS

    更新日期:2004-01-01 00:00:00

  • Use of Magnetic Resonance Imaging to Predict Quadrupled Semitendinosus Graft Diameter in All-Inside Anterior Cruciate Ligament Reconstruction.

    abstract::This study was conducted to evaluate whether preoperative magnetic resonance imaging (MRI) measurements of the cross-sectional area and length of the semitendinosus tendon correlated with graft diameter. The goal of the study was to identify tendons at risk for requiring graft augmentation. The records of 140 consecut...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20170418-02

    authors: Serino J,Murray R,Argintar EH

    更新日期:2017-07-01 00:00:00

  • Early postoperative outcomes between arthroscopic and mini-open repair for rotator cuff tears.

    abstract::The purpose of this study was to compare early postoperative outcomes between arthroscopic and mini-open repair for rotator cuff tears smaller than 3 cm to determine whether arthroscopic repair causes less postoperative pain and allows for faster recovery of range of motion. Sixty patients scheduled for rotator cuff r...

    journal_title:Orthopedics

    pub_type: 杂志文章,随机对照试验

    doi:10.3928/01477447-20120822-20

    authors: Cho CH,Song KS,Jung GH,Lee YK,Shin HK

    更新日期:2012-09-01 00:00:00

  • Instability in primary total knee arthroplasty.

    abstract::Instability is one of the most common causes of failure of total knee arthroplasty (TKA). The presentation can vary from pain to frank dislocation with the etiologies just as varied. Instability after TKA can be classified by where the instability occurs in the knee's arc of motion as well as the chronicity of the pro...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20110714-46

    authors: Del Gaizo DJ,Della Valle CJ

    更新日期:2011-09-09 00:00:00

  • Orthopedic Surgeons' Management of Elective Surgery for Patients Who Use Nicotine.

    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

    authors: Lilley M,Krosin M,Lynch TL,Leasure J

    更新日期:2017-01-01 00:00:00

  • Posterior thigh compartment syndrome as a result of a basketball injury.

    abstract::Acute compartment syndrome of the thigh is a serious although rare occurrence that was sparsely documented in the orthopedic literature until Schwartz et al reported on a series of 21 cases. Although classically associated with high-energy femur fracture, thigh contusion, or the use of military anti-shock trousers, co...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20091020-19

    authors: Mallo GC,Stanat SJ,Al-Humadi M,Divaris N

    更新日期:2009-12-01 00:00:00

  • An Assessment of International Classification of Diseases, 10th Revision, Clinical Modification, Codes Used to Describe Common Pediatric Orthopedic Conditions.

    abstract::The diagnosis coding system for health care providers that is used in the United States recently converted from the International Classification of Diseases, 9th Revision (ICD-9), to the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM). The authors are unaware of any studies s...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20200107-02

    authors: Rabenhorst BM,Blasier RD

    更新日期:2020-03-01 00:00:00

  • Three decades of experience with unicompartmental knee arthroplasty: mistakes made and lessons learned.

    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

    authors: Scott RD

    更新日期:2006-09-01 00:00:00

  • Upper-extremity thrombosis in a patient after biceps tenodesis.

    abstract::Deep venous thrombosis (DVT) of the upper extremity is uncommon compared with DVT of the lower extremity. Exertional DVT has been described in some athletes, especially in the dominant arm of baseball players. It is important for health care professionals to recognize the signs and symptoms of upper-extremity DVT, whi...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20141124-92

    authors: Offoha RU,Garzon-Muvdi J,Streiff MB,McFarland EG

    更新日期:2014-12-01 00:00:00

  • Metal Allergy as a Cause of Implant Failure in Shoulder Arthroplasty.

    abstract::Metal allergy is an uncommon and poorly understood cause of failure of orthopedic implants. To the authors' knowledge, there have been no reports of the management of shoulder arthroplasty patients with metal allergy. The authors present their experience with the diagnosis and management of patients with metal allergy...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20170719-01

    authors: Ko JK,Nicholson TA,Hoffler CE,Williams G Jr,Getz C

    更新日期:2017-09-01 00:00:00

  • Peri-implant Fractures Following Hook Plate Fixation for Unstable Distal Clavicle Fractures.

    abstract::Clavicle hook plate is a common implant for treating distal clavicle fracture. Although high bone union rate and good functional outcome have been reported, so have several complications, such as osteolysis and fracture of the acromion, loss reduction, hook impingement, and rotator cuff tear. Peri-implant fracture ove...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20200619-01

    authors: Ni PL,Lin KC,Chen CY,Tarng YW,Chang WN,Renn JH

    更新日期:2020-09-01 00:00:00

  • Legal liability and orthopedic surgery.

    abstract::Civil Liability and the Investigational Device Exemptions. ...

    journal_title:Orthopedics

    pub_type: 社论

    doi:10.3928/0147-7447-19801201-13

    authors: Zweng MS

    更新日期:1980-12-01 00:00:00

  • Distal femoral osteotomy for valgus deformity of the knee.

    abstract::Distal femoral varus osteotomy and blade-plate fixation for valgus deformity of the knee proved effective in restoring axial alignment in 18 of 36 knees (34 patients). Patients were followed for an average of 5.4 years (range: 2 to 19 years). The osteotomies were performed on 14 men and 22 women (average age: 44 years...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Terry GC,Cimino PM

    更新日期:1992-11-01 00:00:00

  • Distal Locking Screws for Intramedullary Nailing of Tibial Fractures.

    abstract::Recently introduced tibial intramedullary nails allow a number of distal screws to be used to reduce the incidence of malalignment and loss of fixation of distal metaphyseal fractures. However, the number of screws and the type of screw configuration to be used remains obscure. This biomechanical study was performed t...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20160129-02

    authors: Agathangelidis F,Petsatodis G,Kirkos J,Papadopoulos P,Karataglis D,Christodoulou A

    更新日期:2016-03-01 00:00:00