scholarly journals Comparison of Intra-Articular versus Intravenous Application of Tranexamic Acid in Total Knee Arthroplasty: A Prospective Randomized Study

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Kornah BA ◽  
◽  
Mansour GM ◽  
Mohamed MTI ◽  
◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
University Hospital ◽  
Postoperative Blood Loss ◽  
Soft Tissue Release ◽  
P Value ◽  
Intravenous Application ◽  
Total Knee

Background: Total Knee Arthroplasty (TKA) is widely used in clinical applications. Considerable postoperative blood loss, however, is an unavoidable occurrence due to the extensive soft-tissue release, and the large area of cancellous bone osteotomy associated with the procedure. Besides, knee flexion and extension activities those begin the day after the operation adds to the problem. Aim of the Work: To compare between the intra-articular and the intravenous application of Tranexamic Acid (TXA) in total knee arthroplasty. Patients and Methods: It is a prospective Double-blinded Randomized controlled trial. This prospective study was conducted at El-Hussein University Hospital & El Agouza Hospital on 30 patients who undergo total knee arthroplasty and fulfill all inclusion and exclusion criteria. Results: The results were the average total blood loss in the drain after 48hrs. In the 1st group was 365±74.722 while average blood loss in the 2nd group was 575±88.976. This indicates a significant decrease in blood loss in the 1st group (intraarticular TXA group) than the 2nd group (intravenous TXA group) the P value <0.001 which is highly significant. It was found that The decrease in Hb level is less in the 1st group than in the 2nd group which indicates less postoperative anemia in the blood count, the P-value <0.05 considered significant.

Topical Application of Tranexamic Acid Reduces Postoperative Blood Loss in Total Knee Arthroplasty

2010 ◽  
Vol 92 (15) ◽  
pp. 2503-2513 ◽  
Author(s):  
Jean Wong ◽  
Amir Abrishami ◽  
Hossam El Beheiry ◽  
Nizar N Mahomed ◽  
J Roderick Davey ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Topical Application ◽  
Knee Arthroplasty ◽  
Postoperative Blood Loss ◽  
Total Knee

Efficacy and Safety of Fibrin Glue and Tranexamic Acid to Prevent Postoperative Blood Loss in Total Knee Arthroplasty

2013 ◽  
Vol 95 (22) ◽  
pp. 2001-2007 ◽  
Author(s):  
X. Aguilera ◽  
M.J. Martinez-Zapata ◽  
A. Bosch ◽  
G. Urrútia ◽  
J.C. González ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Fibrin Glue ◽  
Knee Arthroplasty ◽  
Postoperative Blood Loss ◽  
Efficacy And Safety ◽  
Total Knee

scholarly journals Intra-articular tranexamic acid as an adjunct to intravenous tranexamic acid for simultaneous bilateral total knee arthroplasty: a randomized double-blind, placebo-controlled trial

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Sachiyuki Tsukada ◽  
Kenji Kurosaka ◽  
Masahiro Nishino ◽  
Tetsuyuki Maeda ◽  
Yoshiharu Yonekawa ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
University Hospital ◽  
Allogenic Blood Transfusion ◽  
Allogenic Blood ◽  
Perioperative Blood Loss ◽  
Total Knee ◽  
Simultaneous Bilateral Tka

Abstract Background Intra-articular tranexamic acid (TXA) as an adjunct to intravenous TXA was reported to decrease perioperative blood loss during unilateral total knee arthroplasty (TKA). However, there have been no randomized controlled trials comparing intravenous versus combined intravenous and intra-articular TXA administration in patients undergoing simultaneous bilateral TKA. Methods We randomly assigned 77 patients with 154 involved knees undergoing simultaneous bilateral TKA to the intravenous TXA group (intra-articular placebo for each knee) or combined TXA group (1000 mg of intra-articular TXA for each knee) with 1:1 treatment allocation. In both groups, 1000 mg of TXA was given intravenously twice, just before surgery and 6 h after the initial administration. Other perioperative medications, surgical procedures, and blood management strategies were the same for all patients. The primary outcome was perioperative blood loss calculated from blood volume and change in hemoglobin from preoperative to postoperative day 3. Results Intention-to-treat analysis showed no statistically significant differences in perioperative blood loss until postoperative day 3 (1067 ± 403 mL in the intravenous TXA group vs. 997 ± 345 mL in the combined TXA group [95% CI, − 240 to 100 mL], P = 0.42). No patients required allogenic blood transfusion. The incidence of thrombotic events did not differ between groups (12% in the intravenous TXA group vs. 9% in the combined TXA group; P = 0.73). Conclusions The addition of intra-articular TXA did not reduce perioperative blood loss in patients undergoing simultaneous bilateral TKA compared with placebo. Trial registration University Hospital Medical Information Network UMIN000026137. Registered 14 February 2017.

scholarly journals EFFICACY OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS IN TOTAL KNEE ARTHROPLASTY

2018 ◽  
Vol 26 (1) ◽  
pp. 63-66 ◽  
Author(s):  
DAVID SADIGURSKY ◽  
LARISSA MARTINS ARAUJO ◽  
ROGÉRIO JAMIL CARNEIRO FERNANDES
Keyword(s):  
Clinical Trials ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Randomized Clinical Trials ◽  
Postoperative Blood Loss ◽  
Keywords Knee ◽  
Level Of Evidence ◽  
Total Knee

ABSTRACT Objective: To evaluate the efficacy of tranexamic acid in reducing blood loss in total knee arthroplasty by examining the existing literature. Method: This literature review investigated the use of tranexamic acid in knee arthroplasty. The search was performed in the Pubmed, Science Direct, Google Scholar, and Lilacs databases over a 20-year period using the keywords: “knee arthroplasty, tranexamic acid, and efficacy”. Only randomized clinical trials published between 2000 and 2016 in English, Spanish, or Portuguese were accepted, and only trials which scored above 3 on the Jadad scale were selected. Results: A total of 7 randomized clinical trials met the inclusion criteria, with a sample of 948 patients. Conclusion: The use of tranexamic acid in total knee arthroplasty (unilateral or bilateral) reduces perioperative and postoperative blood loss more than other available antifibrinolytics. With this reduction in total blood loss and the need for blood transfusions without any increase in side effects, the use of tranexamic acid can be considered safe and effective in controlling bleeding after knee arthroplasties. Level of Evidence II; Systematic review.

scholarly journals Multimodal Peri-articular Injection with Tranexamic Acid can reduce postoperative blood loss versus Intravenous Tranexamic Acid in Total Knee Arthroplasty: A Randomized Controlled Trial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Hui-ming Peng ◽  
Wei Wang ◽  
Jin Lin ◽  
Xi-sheng Weng ◽  
Wen-wei Qian ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Total Blood Loss ◽  
Postoperative Blood Loss ◽  
Total Blood ◽  
Randomized Controlled ◽  
Hidden Blood Loss ◽  
Total Knee

Abstract Background Tranexamic acid (TXA) has shown significant reductions in blood loss and transfusion rates in total knee arthroplasty (TKA). However, the optimal administration route continues to be debated. The aim of this trial was to compare the effectiveness of intravenous (IV) versus peri-articular injection (PAI) application of tranexamic acid in patients undergoing total knee arthroplasty. Methods We conducted a randomized controlled, double-blinded study. A total of 93 patients undergoing primary unilateral TKA were randomly distributed between 2 groups: the IV group (47 cases; 1 g TXA IV) and the PAI group (46 cases; 1 g TXA injected peri-articularly). The amount of total and hidden blood loss (HBL), drainage, transfusion rate, hemoglobin and hematocrit drift, and complications were recorded. Results Peri-articular injection of TXA reduced total blood loss (P < 0.001) and HBL more than IV use of TXA (P < 0.001). No patients in either group received a transfusion. No symptomatic deep venous thrombosis or other severe complications occurred. Conclusion Peri-articular injection of TXA significantly reduced total blood loss and hidden blood loss to a greater degree than IV injection in total knee arthroplasty without reduction of drainage volume. Trial registration Chinese Clinical Trial Registry, ChiCTR-INR-16010270. Date of registration: December 27, 2016.

Intravenous use of tranexamic acid reduces postoperative blood loss in total knee arthroplasty

2014 ◽  
Vol 134 (11) ◽  
pp. 1609-1614 ◽  
Author(s):  
Luigi Sabatini ◽  
Francesco Atzori ◽  
Stefano Revello ◽  
Luca Scotti ◽  
Fabrizio Debiasi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Postoperative Blood Loss ◽  
Total Knee
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