A comparison of the effects on postoperative bleeding of the intra-articular application of tranexamic acid and adrenalin in total knee arthroplasty (original) (raw)
Related papers
Scholars Journal of Applied Medical Sciences
Original Research Article Osteoarthritis of knee leads to disability and effects quality of life due to pain and deformity in advanced cases. Knee replacement is one of most successful surgery for osteoarthritis knee. This surgery improves pain and function of patient but is associated with substantial blood loss during and after the surgery. Tranexamic acid is commonly used to decrease post-operative blood loss by various routes i.e. oral, intravenous and intra-articular .Objective of study is to evaluate the effect of intra-articular Tranexamic acid on post-operative blood loss after unilateral primary total knee arthroplasty (TKA). A total of 50 patients of either gender planned to undergo unilateral total knee replacement (TKR) were enrolled in each of the two groups. In group A (Control group) no intra articular drug is injected. In Group B (study group), patients were given 2 gram intra articular Tranexamic acid. All patients were followed up to 72 hours from completion of surgery. Blood collection in negative suction drain was noted after every 24 hours. In the study group, the post-operative drainage blood loss was 550.36±72.81 significantly less (p<0.05) than those in the control group that was 1008.12±111.62. Intra-articular application of Tranexamic Acid is effective in decreasing the drainage blood loss after primary TKA treatment.
Revista de Gestão e Secretariado (Management and Administrative Professional Review)
Tranexamic acid (TXA) is frequently administered intravenously because it is recognized as a safe and effective procedure. This study's objective is to evaluate the effectiveness of intravenous and intra-articular TXA treatments in patients who have had primary unilateral knee joint replacement. Patients were divided into groups based on TXA applications. Group A patients, those who received intravenous TXA, Group B patients, those who received intraarticular TXA, and Group C patients were intended to serve as the control group. Age, gender, ASA scores, length of hospital stay, preoperative, postoperative, and discharge hemoglobin and hematocrit levels, and the quantity of blood product transfusion given to the patients was analyzed retrospectively. Analysis of the patient’s postoperative Hb values revealed that group C patients had lower Hb values (p < 0.05). Postoperative Hct levels were also seen to be significantly lower in group C individuals (p < 0.05). When the pati...
International Journal of Orthopaedics, 2019
Total knee arthroplasty (TKA) is associated with significant postoperative blood loss necessitating blood transfusion. Tranexamic acid is an antifibrinolytic drug that has shown good efficacy in reducing this postoperative morbidity. Although, the most commonly used route of administration is intravenous; the optimal route of administration has not been agreed upon. AIM: The aim of this study was to evaluate and compare the efficacy and safety of intravenous and intra-articular administration of tranexamic acid in reducing blood loss following TKA. METHOD: The study was a prospective, interventional; randomized controlled study involving 63 patients who underwent unilateral uncomplicated TKA for severe osteoarthritis of the knee at the National Orthopaedic Hospital, Dala – Kano, Nigeria. The patients were randomized into 3 groups using online random team generator; (1) Intravenous group, (2) Intraarticular group and (3) Control group. RESULTS: The postoperative blood loss was significantly greater in the control group than in intravenous and intraarticular groups (p = 0.02). Also, the postoperative fall in Hb level and the need for blood transfusion were significantly higher in the control group than in intravenous and intraarticular groups (0.00). However, Intravenous and Intraarticular groups did not differ significantly in terms of the measured variables. There was no significant difference between the preoperative and postoperative platelet counts (p = 0.81), INR (p = 0.21) and serum creatinine (p = 0.39) in all the three study groups. CONCLUSION: Intravenous and intraarticular tranexamic acid were equally effective and safe for reducing blood loss after TKA. Key words: Intravenous; Intraarticular; Tranexamic acid; Total knee arthroplasty; Blood loss
International Journal of Research in Orthopaedics
Background: One of the substantial complications of total knee arthroplasty is major blood loss. Postoperative blood loss can range up to 2000 ml and 10-38% of patients may require blood transfusion. Among the sundry methods of preventing this prob, tranexamic acid, an anti-fibrinolytic, is one of the most effective options. It can be administered directly into the blood or injected locally. The purpose of this study was to compare the hemostatic effects of intraarticular versus intravenous administration of tranexamic acid in primary total knee arthroplasty. Methods: A prospective comparative observational study was done from done September 2020 to February 2022 at Civil Service Hospital, Kathmandu. 64 patients randomized into two groups: an intraarticular tranexamic acid group (31 patients who received 3.0 grams of intraarticular tranexamic acid) and intravenous tranexamic acid group (31 patients who received 15 mg/kg intravenous tranexamic acid in two instances). The primary meas...
Acta orthopaedica et traumatologica turcica, 2016
The aim of this study was to analyse the effectiveness of single dose of 20 mg/kg intravenous tranexamic acid (TXA), in reducing the blood loss in patients undergoing total knee arthroplasty (TKA). 70 patients (65.5 ± 8.1 years old) that have undergone TKA were divided in two groups. The 20 mg/kg IV TXA was given before the skin incision to one group (study group). On the control group, TKA was performed without TXA. The demographic data, body mass index, amount of bleeding and erythrocyte infusion during the operation, hemoglobin and hematocrit values (preoperative and 48th hour), the amount of drainage after the operation were compared between the groups. The total amount of bleeding in the study group was 634.03 ± 182.88 ml and 1166.42 ± 295.92 ml in the control group (p < 0.001). Perioperative bleeding was 252.01 ± 144.13 ml in the study group and 431.33 ± 209.10 ml in the control group (p = 0.018). The drainage after the operation was 311.11 ± 141.64 ml at the 24th hour in t...
Intra-articular injection of tranexamic acid to reduce blood loss after total knee arthroplasty
Journal of orthopaedic surgery (Hong Kong), 2014
To evaluate the effect of intra-articular tranexamic acid (TXA) on blood loss after total knee arthroplasty (TKA). Medical records of 73 men and 93 women (mean age, 68 years) who underwent primary TKA for osteoarthritis and received intra-articular TXA 1500 mg (n=56) or 3000 mg (n=56) or not at all (n=54) were reviewed. Reduction in haemoglobin levels on days 1 and 2 was measured, as were the rates of venous thromboembolism (VTE) and blood transfusion. Reduction in haemoglobin levels on day 2 was significantly greater in controls (35 ± 11 g/dl) than the 1500 mg TXA group (29 ± 9 g/dl, p=0.005) and the 3000 mg TXA group (23 ± 10 g/dl, p<0.001). The difference between the 2 TXA groups was also significant (p=0.002). There was a dose-dependent effect of TXA on blood loss. The rates of VTE and blood transfusion did not differ significantly between groups. Intra-articular administration of TXA is effective in reducing blood loss after TKA, without increasing the risk of VTE.
Knee surgery & related research, 2016
Total knee arthroplasty (TKA) accompanies the risk of bleeding and need for transfusion. There are several methods to reduce postoperative blood loss and blood transfusion. One such method is using tranexamic acid during TKA. The purpose of this study was to confirm whether tranexamic acid reduces postoperative blood loss and blood transfusion after TKA. A total of 100 TKA patients were included in the study. The tranexamic acid group consisted of 50 patients who received an intravenous injection of tranexamic acid. The control included 50 patients who received a placebo injection. The amounts of drainage, postoperative hemoglobin, and transfusion were compared between the groups. The mean amount of drainage was lower in the tranexamic acid group (580.6±355.0 mL) than the control group (886.0±375.5 mL). There was a reduction in the transfusion rate in the tranexamic acid group (48%) compared with the control group (64%). The hemoglobin level was higher in the tranexamic acid group t...
Blood loss after intraarticular and intravenous tranexamic acid in total knee arthroplasty
JPMA. The Journal of the Pakistan Medical Association, 2018
To compare postoperative blood loss after intravenous and intraarticular tranexamic acid injection in patients of bilateral total knee arthroplasty. This comparative randomised study was conducted at Ghurki Trust Teaching Hospital, Lahore, between July 2015 and January 2016, and comprised all patients admitted for bilateral total knee replacement. Patients were randomly divided into two equal groups. Group-A received intraarticular while Group-B received intravenous injection of 1.5 gmtranexamic acid. All data was analysed using SPSS 17. The total 140 patients were divided into two equal groups of 70(50%) each. In Group-A there were 32(45.7%) males and 38(54.3%) females, while in Group-B, there were 28(40%) males and 42(60%) females. The mean ages were 64.39±9.07 years in Group-A and 63.30±9.51 years in Group B. Blood loss in Group-A was significantly lower than Group-B (p=0.01).. Intraarticular administration of tranexamic acid was more effective than intravenous administration in ...
Effect of Tranexamic Acid on Bleeding Control in Total Knee Arthroplasty
Acta Ortopedica Brasileira, 2016
Objectives: To analyze the effectiveness of intravenous (IV) tranexamic acid (TA) in reducing blood loss in total knee arthroplasty (TKA). Method: The population sample was composed of patients with a diagnosis of primary knee osteoarthritis. The patients undergoing TKA were divided in two groups. Group A: comprised patients who used IV TA and B group, formed by patients who did not use TA in the intra or post-operative period. For descriptive analysis, quantitative variables were represented by mean and standard deviations when their distribution was normal and interquartile ranges and medians for non-normal variables. Results: The mean age of patients was 68 years old, most of them were female and with involvement of the left knee. Postoperatively patients who had used IV TA showed less bleeding rate and less hemoglobin rate reduction. Conclusion: The use of IV TA in TKA reduces blood loss in peri-and postoperative periods. Regarding total blood loss reduction, hemoglobin rate and need for blood transfusions, IV TA should be used routinely during TKA since it has been shown to be safe with no increase in side effects as thromboembolic events. Level of Evidence III. Retrospective Comparative Study.