The Effect of Tranexamic Acid and Tourniquet Use on Tibial Cement Penetration in Primary Total Knee Arthroplasties

Overview

Journal Arthroplast Today

Publisher Elsevier

Date 2020 Jul 3

PMID 32613048

Citations 7

Authors

Yasar Mahsut Dincel

Abdulkadir Sari

Mehmet Umit Cetin

Burak Gunaydin

Emre Agca

Abdullah Heysem Dogan

Rustem Varol

Affiliations

Soon will be listed here.

Abstract

Background: In this study, our aim was to compare the effects of tourniquet and tranexamic acid (TXA) use on tibial cement penetration in primary total knee arthroplasty (TKA) using radiograph images. In addition, we also aimed at investigating the effects of age, gender, body mass index (BMI), and bone mineral density on cement penetration.

Methods: One hundred seventy patients who underwent TKA for primary osteoarthritis were retrospectively evaluated. TXA was administered to patients in group 1 (n = 96), and tourniquet application was used in patients in group 2 (n = 74). Tibial cement penetration was evaluated radiologically on a total of 4 zones: 2 anteroposterior and 2 lateral zones. In addition, age, gender, BMI, and bone mineral density were recorded in each group.

Results: The mean cement penetration in the total study population was 2.34 ± 0.24 mm, with a mean of 2.33 ± 0.25 mm in the TXA group and a mean of 2.35 ± 0.24 mm in the tourniquet group ( = .453). A negative correlation was detected between BMI and anteroposterior 1 values in the total and TXA groups ( = .022 and = .029). In the evaluation of the differences between genders, significantly higher penetration values were observed only in the females in the tourniquet group ( = .024).

Conclusions: The use of TXA instead of a tourniquet does not reduce the depth of cement penetration in TKA. The clinical implications of individual-induced penetration differences may be significant for future implant survival.

Citing Articles

Comparison of medium- and long-term total knee arthroplasty follow-up with or without tourniquet.

Zhong Q, Yang H, Qi R, Zhang T, Zhan J, Yao Y BMC Musculoskelet Disord. 2025; 26(1):205.

PMID: 40016694 PMC: 11866867. DOI: 10.1186/s12891-025-08462-w.

Randomized Controlled Trial of Irrigation-Coupled Bipolar Electrocautery Versus Tourniquet in Total Knee Arthroplasty.

Landy D, Mounce S, Sabatini F, Chapek J, Conley C, Duncan S Arthroplast Today. 2024; 27:101364.

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Controlled hypotension technology can improve patient recovery in the early postoperative period after total knee arthroplasty: A prospective, randomized controlled clinical study.

Li X, Liu J, Wang H, Ding Y Jt Dis Relat Surg. 2023; 35(1):36-44.

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Fang Q, Zhang Z, Wang D, Wang L, Xiong W, Tang Y Orthop Surg. 2022; 14(9):1940-1950.

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