1.
Modified Robert Jones bandage can not reduce postoperative swelling in enhanced-recovery after primary total knee arthroplasty without intraoperative tourniquet: a randomized controlled trial
Yu H, Wang H, Zhou K, Rong X, Yao S, Pei F, Zhou Z
Bmc Musculoskeletal Disorders. 2018;19((1)):357.
Abstract
BACKGROUND Compression therapy is commonly used to reduce lower limb swelling and blood loss after knee surgery. This study was performed to investigate whether modified Robert Jones bandage (MRJB) as a postoperative compression therapy is necessary for enhanced-recovery primary total knee arthroplasty without the tourniquet application. METHODS In this prospective randomized controlled trial, 90 patients were grouped into 2 groups randomly. The experimental group received compression therapy with MRJB from toes to thigh for 24 h and the control group received no compression therapy. Knee swelling, blood loss, range of motion (ROM), pain, patient reported comfort level and complications were recorded. RESULTS No significant differences were observed between the two groups when we compared knee swelling. Similarly, no significant difference on postoperative blood loss, pain, ROM, complications was found. However, patients in control group had significantly higher comfort ratings than compression group during the first 24 h. CONCLUSIONS MRJB is not routinely indicated in enhanced-recovery primary total knee arthroplasty without tourniquet application. TRIAL REGISTRATION The trial was registered in the Chinese Clinical Trial Registry ( ChiCTR-INR-16010177 ) dated 18th December 2016.
2.
Tranexamic acid reduces postoperative blood loss of degenerative lumbar instability with stenosis in posterior approach lumbar surgery: a randomized controlled trial
Wang Q, Liu J, Fan R, Chen Y, Yu H, Bi Y, Hua Z, Piao M, Guo M, Ren W, et al
European Spine Journal. 2013;22((9):):2035-8.
Abstract
STUDY DESIGN This study is randomized controlled trial. PURPOSE To evaluate the effect of tranexamic acid (TXA) on reducing postoperative blood loss in posterior approach lumbar surgery for degenerative lumbar instability with stenosis. METHODS Sixty patients with degenerative lumbar instability with stenosis were randomized into TXA and control groups, receiving 15mg/kg body weight of TXA or placebo (0.9% Sodium chloride solution) intravenously, respectively, before the skin incision was made. The operation of pedicle screw system fixation was performed for all patients, and then selective laminectomy and posterior lumbar interbody fusion (PLIF) were carried out. Intraoperative and postoperative blood loss were compared between the two groups. And the complication of TXA was also investigated. RESULTS There were no statistically significant differences between the TXA and control groups in terms of age, sex, body mass index, and operation time. There was no significantly difference in intraoperative blood loss between the two groups. However, in the TXA group, postoperative blood loss was significantly lower than that in the control group (13.0%). Especially, postoperative blood loss during the first 12h was reduced by 29.9% as compared to the control group. There were no thromboembolic events or other complications occurred in either group. CONCLUSIONS Preoperative single-dose TXA can significantly reduce postoperative blood loss in posterior approach lumbar surgery, and there were no significant side effects.