Consideration of the Methods for Hemostasis in Uncemented Total Knee Replacement

Abstract

We evaluated various hemostasis methods in 131 operations of uncemented total knee replacement with rheumatoid arthritis patients. Those methods were intended to reduce the volume of intra- and post-operative bleeding and total blood transfusion. The results were as follows: 1. Less blood loss was observed and less blood transfusion was needed when the tourniquet was released after skin closure and a pressure dressing was applied than when the tourniquet was released before closure. 2. Less blood loss was seen and less transfusion was necessary when the tourniquet was released with intracapsular pressure raised by injection of isotonic sodium chloride solution and by clamping the suction drain for one hour after the pressure dressing was applied than when the tourniquet was released without the pressure raised. 3. Less intraoperative blood loss was observed when bone wax was impregnated at the exposed cut surfaces of cancellous bones after inserting the prosthesis.