Efficacy and Safety of Intravenous Combined with Topical Administration of Tranexamic Acid in Reducing Blood Loss in Opening Wedge High Tibial Osteotomy Procedure: A Retrospective Case-control Study

Overview

Journal Acta Orthop Traumatol Turc

Specialties Emergency Medicine
Orthopedics

Date 2022 Apr 13

PMID 35416160

Authors

Wei Luo

Xin Fu

Jing-Min Huang

Jiang Wu

Xin-Long Ma

Affiliations

Soon will be listed here.

Abstract

Objective: This study aimed to evaluate the efficacy and safety of intravenous combined with topical application of tranexamic acid (TXA) in reducing blood loss in opening wedge high tibial osteotomy (OWHTO).

Methods: A total of 60 patients who underwent unilateral OWHTO between May 2018 and May 2019 were retrospectively reviewed. All the patients were then divided into one of the two groups (30 per group): the TXA group, patients receiving intravenous combined with topical application of TXA, and the control group, patients receiving no TXA. Outcome measures were drain volume, total blood loss, hidden blood loss, transfusion requirements, and incidence of complications.

Results: The mean follow-up of TXA group was 14.2 2.3 months (range, 13-16 months) and the mean follow-up for the control group was 14.4 2.1 months (range, 13-17 months). No significant difference was found for the follow-up of two groups (P=0.829). Drainage volume (143.3 65.4 ml vs 307.8 51.4 mL, P < 0.001), hidden blood loss (156.7 63.8 mL vs 286.4 79.1 mL, P < 0.001) and knee swelling (3.2 0.9 vs 6.5 2.1, P < 0.001) in the TXA group was clearly less than that in the control group, and there was no statistical significance with regard to hospitalization time (P=0.746), transfusion requirements (P=1.000), wound complications (P=0.386), deep venous thrombosis (P=1.000), postoperative Lysholm knee score (P=0.681) and Knee Injury and Osteoarthritis Outcome subscales pain (P=0.752), symptoms (P=0.673), activities of daily living (P=0.871), sport/recreation function (P=0.816), and knee-related quality of life (P=0.576) at 6 months postoperatively.

Conclusion: This study has shown that administration of intravenous combined with topical TXA in OWHTO can effectively reduce perioperative blood loss without increasing the incidence of postoperative complications.

Level Of Evidence: Level III, Therapeutic Study.

Citing Articles

Clinical Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review and Meta-analysis.

Xu Z, Li L, Xie P, Gu J, Kang K, Zheng X Orthop J Sports Med. 2024; 12(3):23259671241231761.

PMID: 38455151 PMC: 10919141. DOI: 10.1177/23259671241231761.

Topical Use of Low-dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study.

Zheng H, Han Y, Zhao G, Wang R, Wu J, Chen X Orthop Surg. 2024; 16(4):894-901.

PMID: 38444379 PMC: 10984820. DOI: 10.1111/os.14014.

Clinical Outcomes Following Use of Tranexamic Acid in High Tibial Osteotomy: A Systematic Review.

ODonnell C, Dadah H, Bin Abd Razak H, Wilson A, Khakha R Cureus. 2023; 15(11):e49556.

PMID: 38156174 PMC: 10753147. DOI: 10.7759/cureus.49556.

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