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Intra-operative administration of combined platelet rich fibrin (PRF) and tranexamic acid spray further reduces total blood loss after primary total knee arthroplasty compared to standard of care: a prospective, randomized, controlled trial
ESSKA Academy. Tandogan R. Nov 8, 2019; 284357; epEKA-09 Topic: Joint Replacement
Prof. Reha Tandogan
Prof. Reha Tandogan
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Intra-operative administration of combined platelet rich fibrin (PRF) and tranexamic acid spray further reduces total blood loss after primary total knee arthroplasty compared to standard of care: a prospective, randomized, controlled trial

ePoster - epEKA-09

Topic: TKA

Tandogan R.N.1, Polat M.2, Beyzadeoglu T.3, Karabulut E.4, Kayaalp A.1
1Ortoklinik & Cankaya Orthopedics, Orthopedic Reconstruction, Ankara, Turkey, 2Cankaya Orthopedics, Orthopedics & Traumatology, Ankara, Turkey, 3Halic University & Beyzadeoglu Clinic, Orthopedics & Traumatology, Istanbul, Turkey, 4Hacettepe University, Biostatistics, Ankara, Turkey

Introduction: Total knee arthroplasty (TKA) results in a significant amount of blood loss that may lead to local and systemic adverse events. Several strategies to limit blood loss, notably the use of tranexamic acid have been employed successfully in recent years.
Objectives: The aim of this study was to evaluate the efficacy of intra-operative co-administration of tranexamic acid(TXA) and platelet rich fibrin (PRF) using a proprietary co-delivery system (Vivostat®, Allreoed, Denmark) on the amount of blood loss, early functional outcomes and wound complications after primary TKA. The intervention was compared to the standard of care (combined intravenous and topical TA) in a prospective, randomized, double blind setting.
Aims: It was hypothesized that the co-delivery of PRF and TXA would reduce total blood loss, thereby facilitating early rehabilitation by decreasing pain, increasing knee range of motion and reducing wound drainage and finally reducing length of stay.
Methods: 80 patients undergoing primary cemented TKA without tourniquet were prospectively randomized into control (Topical and intravenous TXA only) and PRF (Co-delivery of topical PRF and TXA) groups after informed consent. Total blood loss, drainage blood loss, knee range of motion, VAS pain scores, length of stay and wound complications were analyzed. Data collection was performed in a double-blind manner on Days 1,3 and 21.
Results: Total blood loss was significantly lower in the PRF group compared to control at day 1 (302cc vs. 407cc, p< 0.001) and day 3 (367cc vs 471cc, p< 0.001). The PRF group had a significantly better median knee extension in the early post-operative period, however this difference evened out at 3 weeks. No significant difference could be demonstrated between the PRF and control groups in length of stay, VAS pain scores, narcotic usage, wound complications and knee flexion at all time points. No adverse events related to the use of PRF were noted.
Conclusions: The co-delivery of PRF with TXA can result in further 22% reduction in total blood loss, compared to standard of care in primary TKA without increase in adverse events.
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