Osteoarthritis of the Knee Clinical Trial
A randomized controlled study is performed to address the question of whether the topical application of a novel fibrin sealant, Evicel (Johnson & Johnson Wound Management, Ethicon, Somerville, NJ) in patient undergoing total knee replacement (TKR) reduce the perioperative blood loss and the need for allogenic blood transfusion compared to a control group. We hypothesize that fibrin sealant decrease the drop in post-operative hemoglobin level after total knee replacement.
Total knee replacement is an invasive surgical procedure that can expose patients to massive
perioperative bleeding. This hematic loss results in a high rate of blood transfusion after
total knee replacement (TKR) with an incidence from 10% to 58%.Methods to prevent the need
for allogenic blood transfusion after TKR include hemodilution, perioperative blood salvage
and reinfusion, hypotensive anesthesia, preoperative autologous blood donation and
intravenous administration of tranexamic acid.
In the last decade, the topical use of fibrin sealant has become a logical surgical
stratagem for reducing blood loss in total knee arthroplasty.Fibrin sealants mimic the final
step of the coagulation cascade reducing blood loss and transfusion requirements.
A novel hemostatic agent derived from banked allogenic human plasma (EVICEL, Johnson &
Johnson Wound Management, Ethicon, Somerville, NJ) is recently available on the market for a
variety of surgical specialty.
A randomized controlled study is conducted to test if the post-operative reduction in
hemoglobin level would be lower in the fibrin sealant group compared to a control group.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
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