A Prospective, Randomized, Comparative Study of Intravenous Alone and Combined Intravenous and Intraarticular Administration of Tranexamic Acid in Primary Total Knee Replacement

Overview

Journal Arthroplast Today

Publisher Elsevier

Date 2018 Mar 22

PMID 29560401

Citations 11

Authors

Paolo Adravanti

Eleonora Di Salvo

Giuseppe Calafiore

Sebastiano Vasta

Aldo Ampollini

Michele Attilio Rosa

Affiliations

Soon will be listed here.

Abstract

Background: Studies on the use of tranexamic acid (TXA) to improve clinical outcomes after joint arthroplasty have reported contrasting results between intravenous (IV) TXA alone and combined IV and intraarticular (IA) administration. We compared the effectiveness of the 2 methods in providing higher postoperative hemoglobin (Hb) levels in patients undergoing primary total knee arthroplasty (TKA).

Methods: A total of 100 TKA patients were randomly assigned to receive either IV TXA alone (group 1) or combined IV and topical IA TXA (group 2). Hb and hematocrit levels were measured before and after surgery. The amount of drained blood and transfused blood for the 2 groups was compared.

Results: The Hb level was significantly higher at postoperative day 4, together with a positive, albeit not significant, trend toward less postoperative blood loss in the group that received combined IV and IA TXA. No postoperative infections or deep venous thrombosis events occurred.

Conclusions: This study reinforces evidence that, as compared to IV TXA alone, combined IV and IA administration of TXA has a synergic effect, leading to higher postoperative Hb levels without influencing drug safety in TKA patients.

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