Topical tranexamic acid in cemented primary total knee arthroplasty without tourniquet: a prospective randomized study
| Autor: | Jesus Mas Martinez, Enrique Martinez Gimenez, Carmen Verdu Roman, David Bustamante Suarez de Puga, Manuel Morales Santias, Javier Sanz-Reig |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Deep vein Administration Topical Blood Loss Surgical Hematocrit Postoperative Hemorrhage law.invention 03 medical and health sciences Hemoglobins 0302 clinical medicine Randomized controlled trial law Thromboembolism medicine Humans Orthopedics and Sports Medicine Blood Transfusion Arthroplasty Replacement Knee Cementation Aged Postoperative Care 030222 orthopedics Tourniquet Blood Volume medicine.diagnostic_test business.industry 030229 sport sciences medicine.disease Thrombosis Antifibrinolytic Agents Pulmonary embolism medicine.anatomical_structure Outcome and Process Assessment Health Care Tranexamic Acid Anesthesia Surgery Female Risk Adjustment Hemoglobin business Tranexamic acid medicine.drug |
| Zdroj: | European journal of orthopaedic surgerytraumatology : orthopedie traumatologie. 30(6) |
| ISSN: | 1432-1068 |
| Popis: | Tranexamic acid (TXA) has been shown to be effective in reducing blood loss after total knee replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use, to reduce blood loss after primary total knee replacement without tourniquet, and to compare these outcomes with a control group that did not receive tranexamic acid. This is a prospective, randomized study to assess the effect of a 2-g topical tranexamic acid in 50 mL physiological saline solution in total knee replacement without tourniquet and drain. Primary outcomes were total blood loss. Secondary outcomes were hemoglobin and hematocrit level, hemoglobin and hematocrit drop, transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. Preoperative and intraoperative data were similar between the two groups. The mean total blood loss was 620 mL in the topical tranexamic acid group and 1094 mL in the control group with significant differences (p = 0.001), which meant 43% reduction in total blood loss. The hemoglobin and hematocrit postoperative value was significantly higher in the topical tranexamic acid group than in the control group (p = 0.002). Transfusion rates were 0% in the topical tranexamic group and 4.3% in the control group. The length of stay was significantly lower in the topical tranexamic acid group (p = 0.01). There were no DVT or PE in any group. A single dose of 2-g TXA in 50 mL topical administration significantly reduces blood loss and improves postoperative blood chemistries in patients undergoing unilateral primary cemented TKA without tourniquet and drain compared to a control group, without increasing the risk of thromboembolic complications. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink