This article is more than 5 years old. Information may no longer be current.
Bone wax seen as effective for decreasing total blood loss after TKA
Click Here to Manage Email Alerts
Results from this study indicated that the use of bone wax in total knee arthroplasty safely and effectively reduced total blood loss and maintained hemoglobin levels higher than those of patients in a control group.
Researchers prospectively randomized 100 patients who underwent primary, unilateral total knee arthroplasty (TKA) with cement. Patients were randomized to either a study group that had 2.5g of bone wax applied to the bone and nail holes prior to tourniquet release or a control group that achieved hemostasis with electrocautery. The hemoglobin balance method was used to calculate total blood loss.
Results showed patients who received bone wax and those in the control group had similar preoperative serum hemoglobin levels. Investigators noted at 24 hours after TKA, the drop in serum hemoglobin levels in the bone wax group and the control group was 1.6 g/dL and 2.1 g/dL, respectively. After 72 hours, the drop in serum hemoglobin levels in the bone wax group and control group was 2.7 g/dL and 3.6 g/dL, respectively.
According to researchers, total blood loss after 72 hours in the bone wax group was 987.9 mL and 1,183.5 in the control group. At the 3-month follow-up, investigators saw no adverse events in patients who received bone wax. – by Monica Jaramillo
Disclosure : The researchers report no relevant financial disclosures.
Perspective
Back to Top
A. Seth Greenwald, DPhil (Oxon)
Stemming blood loss during contemporary, cemented, total knee arthroplasty procedures has largely been accommodated by the use of tranexamic acid (TXA), which has proven to be clinically effective, complication-free and cost-efficient. Nevertheless, bone wax continues to enjoy both historical and contemporary use in the OR. This paper brings to light, in a unique prospective, randomized clinical evaluation, bone wax’s utility in stemming blood loss associated with the uncovered bony surfaces resulting from prosthesis bone cuts and osteophyte removal. The paper demonstrates a statistically significant improvement in stemming blood loss and in serum hemoglobin levels when comparing the bone wax and electrocautery (control) groups of 50 patients each.
Interestingly, this study is done in the absence of TXA. The paper’s significance is further appreciated in its claim to be the first clinical trial in the literature demonstrating the efficacy of bone wax and justifying its continued inclusion in the OR armamentarium during knee reconstructive procedures.
Click Here to Manage Email Alerts