Table 1 Study characteristics - knee

Benoni, 1996[17]

0

10 mg/kg 12 minutes prior to tourniquet deflation + 3 hours later, extra does for severe postoperative bleeding.

IV

S

Hb < 85–100 g/L

Swabs + drain

None.

Dalteparin sodium n = 49, enoxaparin n = 37

Hiippala, 1997[12]

3

15 mg/kg prior to tourniquet deflation + two additional 10 mg/kg doses. 2nd dose 3–4 hours after 1st, 3rd 6–7 hours after 2nd.

IV

S

Hb < 100 g/L

Swabs + drain

Clinical exam +/− venography.

Enoxaparin

Jansen, 1999[2]

0

15 mg/kg 30 minutes prior to surgery and every 8 hours for 3 days

IV

S

Post-op hemocrit <26%

Swabs + drapes + drain

Clinical exam.

Fraxiparine.

Engel, 2001[42]

15 mg/kg + second dose of 10 mg/kg after 3 hrs.

IV

Non-TXA

Hb < 100 g/L

N/R

Clinical exam +/− venography.

N/R

Ellis, 2001[36]

0

15 mg/kg prior to tourniquet deflation + 10 mg/kg/hr until 12 hrs after deflation.

IV

Non-TXA

Hemocrit < 27%

N/R

N/R

Enoxaparin.

Tanaka, 2001[41]

0

20 mg/kg 10 minutes before surgery and/or 20 mg/kg 10 minutes prior to tourniquet release.

IV

S

N/R

Swabs + drain

Venography 7–14 days post-op + perfusion lung scan.

None

Veien, 2002[3]

0

10 mg/kg at end of surgery and repeated three hours later. Max dose = 1 g.

IV

S

Hemocrit < 28%

Swabs + drain

Only those with clinical signs investigated.

Fraxiparine.

Good, 2003[18]

4

10 mg/kg prior to tourniquet release + three hours later.

IV

S

Hb < 90 g/L

Post-op hemoglobin measurement

Clinical exam +/−ultrasound.

Fragmin

Zohar, 2004[35]

0

1) → 15 mg/kg prior to tourniquet release + 10 mg/kg/hr for 12 hours after release.

IV + O

Non-TXA

Hemocrit < 28%

Drain

Clinical exam + ultrasound 5th day post-op

Enoxaparin

OR

2) → 15 mg/kg prior to tourniquet release + 10 mg/kg/hr for 2 hours after + 1 g TXA oral 6 + 12 hours after.

OR

3) → 1 g TXA orally 1 hr before surgery + after surgery every 6 hrs for 18 hrs

Orpen, 2006[5]

0

15 mg/kg at time cement mixing commenced.

IV

S

Post-op Hb < 90 g/L

Swabs + drain + dressings

Ultrasound on both legs 5th day post-op.

Fragmin

Camarasa, 2006[31]

1

10 mg/kg prior to tourniquet deflation then + 3 hours later.

IV

S

Hb < 80 g/L or < 10 g/L dependant on symptoms.

Swabs + dressings + drain

Clinical exam +/− ultrasound.

Dalteparin sodium

Álvarez, 2007[6]

15

10 mg/kg + 1 mg/kg/hr perfusion.

IV

S

Hb < 80 g/L or patients showing signs/symptoms of hypoxia

Drains

Clinical exam.

Bemiparin

Molloy, 2007[19]

0

500 mg tranexamic acid five minutes prior to deflation of tourniquet + three hours later.

IV

Non-TXA

Post-op hemocrit < 25%

Post-op hemoglobin measuremen

Clinical exam.

Aspirin

Kakar 2009[4]

0

10 mg/kg prior to tourniquet deflation + 1 mg/kg/h until wound closure.

IV

S

Hb < 80 g/L or <10 g/L for those over 60 and/or those with cardiopulmonary disease.

Drains

N/R

N/R

Wong, 2010[11]

1

1.5 gm or 3 gm applied to joint for 5 min at end of surgery.

TP

S

Hb < 80 g/L or Hb < 100 g/L if symptoms developed.

Post-op hemoglobin measurements.

Clinical exam + ultrasound on post-op days 2 + 3.

Rivaroxaban or enoxaparin

Sa-ngasoongsong, 2011[24]

0

250 mg /25 mL injected after fascial closure.

IA

S

When hemocrit < 25% Hb measured, Hb < 8gm% or symptoms of anemia.

Formula

Duplex Doppler on 4th postoperative day.

Ankle motion + exercizes.

Ishida, 2011[43]

0

2000 mg/20 mL through intra-articular drain.

IA

S

N/R

Drains

N/R

Arteriovenous impulse system for 24 hours surgery + heparin sodium.

Roy, 2012[37]

0

500 mg/5 mL through two intra-articular drain.

IA

S

Hemocrit ≤28%; Drain collection ≥ 500 mL in 1st 8–10 hours + Hb loss ≥ 4 g/dL; symptoms of amenia.

Weight of swabs.

Only symptomatic cases were evaluated with ultrasonography + CT.

Stockings + early mobilization + Dalteparin