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Thrombin-Based Hemostatic Agent in Primary Total Knee Arthroplasty.

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Thrombin-based hemostatic agents significantly reduce blood loss and transfusion needs in total knee arthroplasty (TKA). This meta-analysis confirms their safety, showing no increased risk of infection or deep vein thrombosis (DVT).

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Area of Science:

  • Orthopedic Surgery
  • Surgical Hemostasis
  • Medical Device Efficacy

Background:

  • Total knee arthroplasty (TKA) is associated with significant blood loss.
  • Effective hemostasis is crucial for patient outcomes and reducing complications in TKA.
  • Thrombin-based hemostatic agents are used to control bleeding during surgical procedures.

Purpose of the Study:

  • To assess the efficacy and safety of thrombin-based hemostatic agents in primary total knee arthroplasty (TKA).
  • To pool data from randomized controlled trials (RCTs) for a comprehensive analysis.

Main Methods:

  • A meta-analysis of four randomized controlled trials (RCTs) was conducted.
  • Data were sourced from major databases including Cochrane Library, Medline, PubMed, Embase, and ScienceDirect.
  • RevMan 5.1 software was used for data pooling and analysis.

Main Results:

  • Thrombin-based hemostatic agent use significantly reduced postoperative hemoglobin decline (p < 0.00001) and total blood loss (p < 0.00001).
  • A significant decrease was observed in drainage volume (p = 0.01) and allogeneic blood transfusion rates (p = 0.01).
  • No significant differences were found in the incidence of infection (p = 0.45) or deep vein thrombosis (DVT; p = 0.80).

Conclusions:

  • Thrombin-based hemostatic agents are effective in reducing blood loss and transfusion requirements in primary TKA.
  • The application of these agents before wound closure does not elevate the risk of infection or DVT.
  • Thrombin-based hemostatic agents are deemed safe and effective for use in primary TKA procedures.