Comparison of Efficacy Safety Between Intravenous and Intraarticular Tranexamic Acid in Reducing Blood Loss after Total Knee Arthroplasty (original) (raw)
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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 ...
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...
Transfusion, 2015
BACKGROUNDTranexamic acid (TXA) has been reported to demonstrate efficacy in reducing blood loss during arthroplasty procedures.STUDY DESIGN AND METHODSThis study examines the effectiveness of TXA as a central element of a patient blood management program (PBMP) by evaluating blood loss and transfusion of red blood cells in three consecutive groups of patients undergoing routine total knee arthroplasty (TKA). Approximately 200 patients were in each group as follows: Group 1 was a control without TXA, Group 2 was intraarticular administration, and Group 3 was intravenous (IV) administration.RESULTSThe IV group demonstrated a small but significant lower blood loss compared to the two other groups measured by hemoglobin (Hb) drift and nadir Hb levels. The routine use of TXA along with the other aspects of our PBMP provided significant cost savings due to the reduction in transfusions as well as a decrease in length of stay and has been an important element of our successful implementat...
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.
Scholars Journal of Applied Medical Sciences
Original Research Article Total Knee Arthroplasty is associated with significant amount of blood loss and may increase the need of blood transfusions. Various blood loss management strategies have been used in the past and Tranexamic Acid is one such commonly used method due to ease of administration and low cost. The use of TXA in primary TKA is associated with reduced transfusion rates, early discharge to home, and reduced economic burden on the patient. Tranexamic Acid can be administered through various routes that include oral, intravenous and intra-articular. However there is no clear consensus on the ideal dosage and route of administration. This study was conducted to compare the effect of intravenous Tranexamic acid with intra-articular Tranexamic acid on post-operative blood loss after unilateral primary total knee arthroplasty (TKA).A total of 58 patients of either gender planned to undergo unilateral total knee replacement (TKR) were enrolled in each of the two groups. In group A (Intra venous Tranexamic acid group) 2 gram intra venous Tranexamic acid was injected. In Group B (Intra-articular Tranexamic acid group), patients were given 2 gram intra-articular Tranexamic acid. All patients were followed up to 72 hours after completion of surgery. Blood collection in negative suction drain was noted after every 24 hours. The mean drainage total blood loss during 72 hours was 637.32±103.53 ml in Group A (intravenous Tranexamic acid)) and 546.35±70.73ml in Group B (Intraarticular Tranexamic acid). The difference was significant in Group A and Group B.Patients who received intraarticular TXA had a lesser drain output (p<0.05) as compared to intravenous administration of Tranexamic Acid. Intra-articular administration of TXA is more effective in reducing postoperative blood loss after primary TKA as compared to intravenous route.
The Journal of Arthroplasty, 2014
Tranexamic acid (TA) has been reported to reduce blood loss after total joint arthroplasty; however, the literature is sparse in evaluating its efficacy in simultaneous bilateral total knee arthroplasty (TKA). In this retrospective study of consecutive patients, TA use in bilateral TKA was associated with a significant reduction in perioperative serum hemoglobin drop, as well as allogeneic blood transfusion needs from 50% to 11% of patients. No autologous blood donation or drains were used. There were no venous thromboembolic events reported. Implementation of a systematic intravenous TA protocol in simultaneous bilateral TKA appears highly effective in reducing transfusion requirements, potentially reducing healthcare resource utilization as well as the morbidity and complications associated with allogeneic blood transfusions.