scholarly journals Tranexamic acid use decreases transfusion rate in children with cerebral palsy undergoing proximal femoral varus derotational osteotomy

Medicine ◽  
2022 ◽  
Vol 101 (2) ◽  
pp. e28506
Author(s):  
Edward Compton ◽  
Rachel Y. Goldstein ◽  
Alexander Nazareth ◽  
Stephen J. Shymon ◽  
Lydia Andras ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Tranexamic Acid ◽  
Transfusion Rate ◽  
Derotational Osteotomy ◽  
Children With Cerebral Palsy

scholarly journals The Value of Tranexamic Acid in Reducing Blood Loss following Hip Reconstruction in Children with Cerebral Palsy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
I. Majid ◽  
S. Alshryda ◽  
B. Somanchi ◽  
E. Morakis ◽  
A. Foster
Keyword(s):  
Cerebral Palsy ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Transfusion Rate ◽  
Hip Reconstruction ◽  
Children With Cerebral Palsy ◽  
Paediatric Orthopaedic ◽  
Randomised Controlled

This is a retrospective study of 51 consecutive hip reconstructions in children with cerebral palsy performed between 2011 and 2013. Tranexamic acid (TXA) was used in 14 hip reconstructions only. Transfusion rate was higher, postoperative Hb was lower, and patients stayed longer in the TXA group. This did not reach a statistical significance (P = 0.75, 0.5, and 0.71, resp.). More than half of the patients who had TXA underwent bilateral hip reconstructions in comparison with 27% only in the non-TXA group. Bilateral hip reconstructions mean more surgery, more blood loss, and more blood transfusion. The patients who had TXA were significantly more disabled as evident by the higher proportions of patient with worse GMFCS levels. Although we have not been able to demonstrate the value of TXA in reducing blood loss and transfusion rate in children with CP who underwent hip reconstruction, it is hoped that an interest in exploring the value of TXA in paediatric orthopaedic surgery is generated. Ideally this should be explored further in an adequately powered, randomised controlled trial where risk of bias is minimized.

scholarly journals Impact of tranexamic acid use on blood loss and transfusion rates following femoral varus derotational osteotomy in children with cerebral palsy

2019 ◽  
Vol 13 (2) ◽  
pp. 190-195 ◽  
Author(s):  
A. Nazareth ◽  
S. J. Shymon ◽  
L. Andras ◽  
R. Y. Goldstein ◽  
R. M. Kay
Keyword(s):  
Cerebral Palsy ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Thromboembolic Complications ◽  
Safety And Efficacy ◽  
Estimated Blood Loss ◽  
Transfusion Requirements ◽  
Derotational Osteotomy ◽  
Venous Thromboembolic Events ◽  
Children With Cerebral Palsy

Purpose Previous studies have established the safety and efficacy of tranexamic acid (TXA) in reducing blood loss after total joint arthroplasty and spinal fusion surgery; however, literature regarding the effectiveness of intraoperative TXA in children with cerebral palsy (CP) is limited. The aim of this study was to investigate the safety and efficacy of intraoperative TXA in reducing blood loss and transfusion requirements for children with CP undergoing a proximal femoral varus derotational osteotomy (VDRO). Methods This is a retrospective review of 258 children with CP who underwent VDRO performed at the author’s institution between 2004 and 2017. In all, 36 subjects underwent VDRO surgery with administration of intravenous TXA and 222 subjects underwent VDRO without administration of TXA. Outcome measures including blood loss, transfusion requirements and venous thromboembolic events were compared between groups using t-tests and chi-squared tests. Results No significant differences were seen in the rates of transfusion between groups for the entire hospitalization (TXA group: 11.1% versus No TXA group: 19.8%), intraoperatively (TXA: 2.8% versus No TXA: 9.0%) or postoperatively (TXA: 8.3% versus No TXA: 14.4%). Intraoperative estimated blood loss (TXA: 144.4 mL versus No TXA: 159.0 mL) and percentage blood loss (TXA: 8.9% versus No TXA: 9.2%) were similar between groups. No major thromboembolic complications events occurred in either group. Conclusion The use of TXA was not associated with thromboembolic complications in this series of children with CP undergoing VDRO surgery. Though there was a trend toward lower rates of intraoperative and postoperative blood transfusion with TXA use in these patients, the differences were not significant, possibly due to low estimated blood loss in both groups and sample size. Level of evidence III- retrospective comparative study

Acetabular Remodeling After a Varus Derotational Osteotomy in Children With Cerebral Palsy

2016 ◽  
Vol 36 (2) ◽  
pp. 198-204 ◽  
Author(s):  
Frank M. Chang ◽  
Julie Ma ◽  
Zhaoxing Pan ◽  
James D. Ingram ◽  
Eduardo N. Novais
Keyword(s):  
Cerebral Palsy ◽  
Derotational Osteotomy ◽  
Children With Cerebral Palsy

Persistence and Recurrence Following Femoral Derotational Osteotomy in Ambulatory Children With Cerebral Palsy

2017 ◽  
Vol 37 (7) ◽  
pp. 447-453 ◽  
Author(s):  
Chris Church ◽  
Nancy Lennon ◽  
Kevin Pineault ◽  
Oussama Abousamra ◽  
Tim Niiler ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Derotational Osteotomy ◽  
Children With Cerebral Palsy

Kinematic and Kinetic Analysis of Distal Derotational Osteotomy of the Leg in Children with Cerebral Palsy

1998 ◽  
Vol 18 (1) ◽  
pp. 81-87 ◽  
Author(s):  
Raymond M. Stefko ◽  
Robert J. de Swart ◽  
David A. Dodgin ◽  
Marilynn P. Wyatt ◽  
Kenton R. Kaufman ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Kinetic Analysis ◽  
Derotational Osteotomy ◽  
Children With Cerebral Palsy

scholarly journals Establishing surgical indications for hamstring lengthening and femoral derotational osteotomy in ambulatory children with cerebral palsy

2020 ◽  
Vol 14 (1) ◽  
pp. 50-57 ◽  
Author(s):  
James McCarthy ◽  
M. Wade Shrader ◽  
Kerr Graham ◽  
Matthew Veerkamp ◽  
Laura Brower ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Surgical Procedures ◽  
Best Practice ◽  
Movement Analysis ◽  
Surgical Indications ◽  
Level Of Evidence ◽  
Derotational Osteotomy ◽  
Children With Cerebral Palsy ◽  
Future Improvement ◽  
Expert Surgeon

Purpose Surgical procedures, such as medial hamstring lengthening (MHL) and femoral derotational osteotomy (FDO), can improve the gait of children with cerebral palsy (CP); however, substantial variation exists in the factors that influence the decision to perform surgery. The purpose of this study was to use expert surgeon opinion through a Delphi technique to establish consensus for indications in ambulatory children with CP. Methods A 15-member panel, all established experts with at least nine years’ experience in the surgical management of children with CP, was created (mean of 20.81 years’ experience). All panel members also had expertise of the use of movement analysis for the assessment of gait disorders in children with CP. The group initially focused on two of the most commonly performed procedures, MHL and FDO, in an attempt to gain consensus (> 80%). This was obtained through a standardized, iterative Delphi process. Results For MHL, a total of 59 questions were surveyed: 41 indication questions and 18 outcome questions, for which there was consensus on ten indication questions and seven outcomes. For FDO, a total of 55 questions were surveyed: 43 indication questions and 12 outcome questions, for which there was consensus on 29 indication questions and eight outcomes. Conclusion This study is the first to use an expert panel to identify best-practice indications for common surgical procedures of children with CP. The results from this study will allow for more informed evaluation of practice and form the basis for future improvement efforts to standardize surgical recommendations internationally. Level of Evidence Level IV

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