Prospective study on the impact of the use of human fibrin sealant free of clot-stabilizing agents in total knee arthroplasty

Abstract

Objective The goal of the present study was to evaluate the results of the intra-operative topical use of a human fibrin sealant free of clot-stabilizing agents in total knee arthroplasties (TKAs), looking for differences between groups in relation to blood loss, transfusional need, length of hospital stay, pain perception, range of motion, and incidence of complications. Methods We have analyzed prospectively an intervention group with 32 patients (Sealant) and a control group with 31 patients (Control) with symptomatic knee osteoarthritis who underwent total knee arthroplasty. Results The results were similar between the groups, in relation to the visible blood loss in the drain in 24 hours (Control 276.5 mL 46.24 versus Sealant 365.9 mL 45.73), the total blood loss in 24 hours (Control 930 mL 78 versus Sealant 890 mL 67) and in the postoperative 60 hours (Control 1,250 mL 120 versus Sealant 1,190 mL 96), the need for blood transfusion (occurred in only 1 control), the length of hospital days stay (Control 5.61 0.50 [n ¼ 31] versus Sealant 4.81 0.36), postoperative pain and range of motion. Its use was not related to the occurrence of wound healing complications, of infection, or of deep venous thrombosis. Conclusion We conclude that the hemostatic agent of human fibrin free of clot-stabilizing agents was not effective in reducing bleeding volume and the need for blood transfusion or in interfering with hospital length of stay, pain perception and range of motion. Its use was not related with any complications.