Stemless anatomic TSA result ed in similar functional outcomes and complication rates to stemmed TSA with decreased operative time and lower blood loss .
BACKGROUND Stemless anatomic total shoulder arthroplasty ( TSA ) is used in the treatment of osteoarthritis of the shoulder joint and other degenerative shoulder diseases .
It has several proposed advantages over stemmed TSA including increased bone preservation , decreased operative time , and easier removal at revision .
The effect of intravenous tranexamic acid on blood loss and early post‐operative pain in total shoulder arthroplasty
Aims The purpose of the present study was to evaluate the impact of intravenous tranexamic acid on the reduction of blood loss , transfusion rate , and early post‐operative clinical outcome in total shoulder arthroplasty . Patients and Methods A r and omised , placebo‐controlled trial which included 54 patients undergoing unilateral primary stemless anatomical or stemmed reverse total shoulder arthroplasty was undertaken . Patients received either 100 ml saline ( placebo , n = 27 ) , or 100 ml saline together with 1000 mg of tranexamic acid ( TXA , n = 27 ) intravenously prior to skin incision and during wound closure . Peri‐operative blood loss via an intra‐articular drain was recorded and total blood loss was calculated . The post‐operative transfusion rate was documented . Assessment of early clinical parameters included the visual analogue scale for pain ( VAS ) , documentation of haematoma formation and adverse events . Results Mean peri‐operative blood drainage ( placebo : 170 ml versus TXA : 50 ml , p = 0.001 ) and calculated mean total blood loss  ( placebo : 1248.2 ml versus TXA : 871.0 ml , p = 0.009 ) were significantly lower in the TXA group . No transfusions were necessary during the study period in either group . Mean VAS for pain significantly decreased from pre‐operative ( VAS 7 ) to the early post‐operative period ( VAS 1.7 , p < 0.001 ) . Significant differences regarding mean post‐operative pain between placebo ( VAS 2.0 ) and TXA ( VAS 1.3 ) were detected ( p = 0.05 ) . The occurrence of haematomas was significantly more frequent in the placebo ( 59.3 % , n = 16 ) than in the TXA group ( 25.9 % , n = 6 , p = 0.027 ) . Whereas only mild haematomas developed in the TXA group , in the placebo group a total of 22.2 % ( n = 6 ) developed either moderate or severe haematomas . No adverse events associated with administration of TXA occurred . Conclusion Intravenous administration of TXA successfully reduced mean peri‐operative blood drainage , total estimated blood loss , pain during the first post‐operative days , and haematoma formation in total shoulder arthroplasty
Stemless anatomic TSA result ed in similar functional outcomes and complication rates to stemmed TSA with decreased operative time and lower blood loss .
BACKGROUND Stemless anatomic total shoulder arthroplasty ( TSA ) is used in the treatment of osteoarthritis of the shoulder joint and other degenerative shoulder diseases .
It has several proposed advantages over stemmed TSA including increased bone preservation , decreased operative time , and easier removal at revision .