Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2014
Knee flexion after total knee arthroplasty reduces blood loss.
Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 5 syntheses or guidelines pooled it, 22 citations in OpenAlex.
- Clinical practice guideline for physical therapist management of total knee arthroplasty: revision 2026.Physical therapy · 2026Guideline
- Physical Therapist Management of Total Knee Arthroplasty.Physical therapy · 2020Guideline
- An updated meta-analysis evaluating limb management after total knee arthroplasty-what is the optimal method?Journal of orthopaedic surgery and research · 2019Pooled it
- Impact of flexion versus extension of knee position on outcomes after total knee arthroplasty: a meta-analysis.Archives of orthopaedic and trauma surgery · 2017Pooled it
- Computer navigation is effective in reducing blood loss but has no effect on transfusion requirement following primary total knee arthroplasty: a meta-analysis.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2016Pooled it
- The effect of post-operative limb positioning on blood loss and early outcomes after primary total knee arthroplasty: a randomized controlled trial.International orthopaedics · 2019Trial
- Trial
- Effect of different postoperative flexion regimes on the outcomes of total knee arthroplasty: randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2017Trial
- Comparison of Blood Loss with the Use of Intravenous and Intraarticular Tranexamic AcidRevista brasileira de ortopedia · 2023Article
- Article
- [The influence of knee flexion position on postoperative blood loss and knee range of motion after total knee arthroplasty].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2020Review
- Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeExtensive blood loss after total knee arthroplasty (TKA) may be a potential problem since it leads to anaemia, increased need for transfusion and prolonged hospitalization. Aim of this study was to investigate the effects of postoperative knee flexion after TKA on blood loss and the need for transfusion.
methodsOne hundred consecutive patients undergoing primary TKA from 2012 to 2013 were randomizely divided into two groups. In one group, the knee was extended for the first 6 h after surgery, whereas in the other was flexed at 90° for the same time. Two doses of endovenous tranexamic acid were administered in all subjects. Patients were homogeneous for all the possible confounding factors.
resultsCalculated blood loss was 846 ± 197 (ml) in the flexion group and 1,242 ± 228 (ml) in the extension group (p < 0.05). Drop of haemoglobin levels at 24 h in the study group and the control group was 1.9 ± 0.8 (g/dl) and 3.0 ± 0.5 (g/dl), respectively (p < 0.01). Drop of haematocrit at 24 h was 4.5 ± 0.2 (%) in the flexion group and 6.7 ± 0.3 (%) in the extension group (p < 0.05). Blood transfusion was necessary in 5 patients in the control group and was not necessary in any patient of the study group. Average knee flexion at day 7 was 105° ± 4° in the flexion group and 98° ± 7° in the extension group.
conclusionKnee flexion at 90° after TKA, associated with the intraoperative use of tranexamic, acid is an effective method to reduce blood loss and the need for blood transfusion. The routine use of the present protocol is effective in reducing social costs and length of hospitalization of TKA procedures.
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