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. 2020 Dec 27;11(1):e107431.
doi: 10.5812/aapm.107431. eCollection 2021 Feb.

Is Intra-Articular Administration of Fibrinogen Effective in Postoperative Total Knee Arthroplasty Blood Loss? A Randomized Clinical Trial

Farahzad Janatmakan  1 , Fatemeh Javaherforooshzadeh  2 , Mohsen Khorrami  3 , Sara Jarirahmadi  2 , Hojjatollah Khademali  2
Affiliations

Is Intra-Articular Administration of Fibrinogen Effective in Postoperative Total Knee Arthroplasty Blood Loss? A Randomized Clinical Trial

Farahzad Janatmakan et al. Anesth Pain Med. .

Abstract

Objectives: The purpose of this study was to evaluate the effect of intra-articular injection of fibrinogen on postoperative bleeding following total knee arthroplasty.

Methods: A double-blind randomized clinical trial was conducted on 40 patients aged 40 - 70 years under spinal anesthesia candidate for total knee arthroplasty in Golestan hospital, Ahwaz, Iran, in 2017-2018. Patients were divided into fibrinogen intra-articular injection (n = 20) and control (n = 20) groups. The amounts of blood loss and blood transfusion requirement were recorded. Hemoglobin (Hb), hematocrit (HCT), international normalized ratio (INR), platelet (PLT), prothrombin time (PT), and partial thromboplastin time (PTT) were recorded before and after the surgery.

Results: There was no significant difference in the average amount of intraoperative blood loss between the groups (P > 0.05). The average amount of blood loss 24 hours after the surgery was significantly lower in the fibrinogen group than in the control group (fibrinogen group 350.61 ± 120.32 cc; control group 540.00 ± 170.21 cc; P = 0.0002). There were significant differences in transfusion between the groups (fibrinogen group 250 ± 20 cc; control group 350 ± 50 cc; P < 0.0001). There was a significant difference between the two groups in 24 h postoperative Hb and HCT (P < 0.001).

Conclusions: Intra-articular fibrinogen administration may reduce acute bleeding and can be used as an effective intervention to prevent further bleeding and the need for transfusion in patients undergoing total knee arthroplasty.

Keywords: Blood Loss; Fibrinogen; Intra-Articular Injection; Total Knee Arthroplasty.

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Conflict of interest statement

Conflict of Interests: The authors of this manuscript have no conflict of interest.

Figures

Figure 1.
Figure 1.. Average 24-hour Hgb (A) and Hct (B) preoperatively and perioperatively in fibrinogen and control groups.
Figure 2.
Figure 2.. CONSORT 2010 Flow Diagram
See this image and copyright information in PMC

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