BACKGROUND: @entity1211 ( @entity1211 ) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) poses substantial risk. Pharmacologic prophylaxis against @entity1211 can cause @entity548 , transfusion, and associated complications. The ActiveCare+SFT is a portable, intermittent pneumatic compression device (IPCD), providing equivalent @entity1211 prophylaxis to pharmacologic agents without associated @entity548 . @entity927 ( @entity928 ) is an antifibrinolytic that reduces @entity190 after THA and TKA. Our objective was to measure blood transfusion and @entity1211 after eliminating enoxaparin, introducing an IPCD, eliminating autologous blood transfusion, and administering @entity928 during primary TKA and THA. METHODS: Four consecutive cohorts of THA and TKA @entity1 were studied. Group A, the historical control, received enoxaparin @entity1211 prophylaxis. Group B received IPCD @entity1211 prophylaxis. Group C received IPCD @entity1211 prophylaxis along with @entity928 (1 g intravenous at incision and closure). Groups A, B, and C predonated 1 unit of autologous blood. Group D received IPCD @entity1211 prophylaxis, @entity928 as above, but did not donate blood preoperatively. RESULTS: Seventeen of 50 @entity1 (34%) in Group A, 7 of 47 (14.9%) @entity1 in Group B, 4 of 43 (9.3%) @entity1 in Group C, and 0 of 46 @entity1 in Group D received transfusions. There were no major symptomatic @entity1211 events. CONCLUSION: Using an IPCD and @entity928 and discontinuing enoxaparin and preoperative autologous blood donation eliminated blood transfusion in primary THA and TKA without any increase in @entity1211 . Using an IPCD instead of enoxaparin, adding @entity928 , and eliminating preoperative autologous donation each had an incremental dose response effect. This protocol provides effective @entity1211 prophylaxis equivalent to pharmacologic methods and eliminates transfusion risk in the primary THA and TKA population.

Balancing Thromboprophylaxis and Bleeding in Total Joint Arthroplasty: Impact of Eliminating Enoxaparin and Predonation and Implementing Pneumatic  Compression and XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity928 :: ('CHEBI:36088', 'Chemical') :: ['TXA'] @entity927 :: ('MESH:D014148', 'Chemical') :: ['Tranexamic acid'] @entity1211 :: ('MESH:D054556', 'Disease') :: ['VTED', 'Venous thromboembolic disease']
@entity927 :: (MESH:D014148,Chemical) :: ['Tranexamic Acid']
