37.
Fibrin sealant has no effect on drain output or functional recovery
following total knee arthroplasty. A randomized, double-blind, placebo-
controlled study in simultaneous bilateral TKA.
Christian Skovgaard Nielsen, Anderes Troelsen, Bente Holm, Troels Lund,
Henrik Kehlet, Henrik Husted
Ortopædkirurgisk Afdeling Hvidovre Hospital; Ortopædkirurgisk Afdeling,
Hvidovre Hospital; Lundbeck center for fast-track hip and knee arthroplasty,
Hvidovre Hospital; Anæstesiologisk Afdeling, Hvidovre Hospital; Section for
surgical pathophysiology, Rigshospitalet; Ortopædkirurgisk Afdeling,
Hvidover Hospital
Background:
Blood loss after total knee arthroplasty (TKA) may lead to
anaemia, blood transfusion(s) and increased total cost. Also, bleeding into the
periarticular tissue may cause swelling and a reduction in quadriceps strength
to impair early functional recovery
Purpose / Aim of Study:
In this study, a prospective, randomized, double-
blind, placebo-controlled study, the potential effect of fibrin sealant on blood
loss and early functional recovery in a fast-track setting was evaluated.
Materials and Methods:
24
consecutive patients undergoing bilateral
simultaneous total knee arthroplasty (BSTKA) were included. 10 ml of fibrin
sealant (Evicel) was sprayed on one knee whereas the contra-lateral knee had
saline. Drain output, the primary outcome, was measured from applied knee
drains exactly 24 h after surgery. Secondary outcomes (knee swelling, pain,
strength of knee extension and range of movement (ROM)) were evaluated up
to 21 days post surgery.
Findings / Results:
Analysing the results showed no significant difference in
the drain output between knees treated with fibrin sealant (582 mL, SD 328)
versus placebo (576 mL, SD 289), (p=0.95). Likewise no significant
differences were found between groups regarding swelling, pain, strength of
knee extension or ROM (all p>0.32).
Conclusions:
Fibrin sealant as a local haemostatic in TKA showed no benefit
in reducing drain output or facilitating early functional recovery.
