A Prospective Study on Role of Tranexamic Acid in Reducing Postoperative Blood Loss in Total Knee Arthroplasty and Its Effect on Coagulation Profile
Section snippets
Material and Methods
The present study was a case control study started from December 2007 to August 2011. We studied all the patients (60 patients) with primary osteoarthritis of both knees undergoing staged bilateral TKA at an interval of 3 weeks who had been administered TEA as per our protocol in their first knee arthroplasty and they were as control in their second knee arthroplasty. Patients with a proven history of thromboembolic disease, cerebrovascular disease, recent myocardial infarction or unstable
Results
The study of 60 cases of bilateral staged TKA had the same patients as cases as well as controls so the study automatically statistically matched.
Mean age of the patients undergoing TKA was 61.5 years with male to female ratio of 7:5. Duration of surgery was 100 min (86–120) for the control group as compared to 91 (81 112) min for the TEA group.
Tourniquet time was 91 min (82–102) for the control group, 80 min (72–92) for the TEA group.
The mean preoperative Hb and preoperative and postoperative Hct
Discussion
The fact that the study was automatically well matched and all the patients in both groups were operated on by the same senior surgeon excluded the possibility of surgeon dependent factors affecting the results and further added strength to our study Various antifibrinolytic agents such as, aprotinin, e-aminocaproic acid and TEA can help reduce blood loss in TKA. Of these TEA is preferred as it is cheaper and less allergenic than aprotinin and is more potent than e-aminocaproic acid. We have
Summary
So we conclude that a dose of 15 mg/kg every 8 h for 24 h would seem appropriate as longer administration of TEA is not accompanied by further reduction in blood loss.
Conflict of Interest Statements
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Cited by (44)
Efficacy of combined use of intravenous and intra-articular versus intra-articular tranexemic acid in blood loss in primary total knee arthroplasty: A randomized controlled study
2021, Journal of Arthroscopy and Joint SurgeryThe antifibrinolytic and anti-inflammatory effects of multiple doses of oral tranexamic acid in total knee arthroplasty patients: a randomized controlled trial
2018, Journal of Thrombosis and HaemostasisHESTAT: Study protocol for a phase II/III, randomized, placebo-controlled, single blind study to evaluate the new hemostatic agent TT-173 in total knee arthroplasty
2017, Contemporary Clinical TrialsCitation Excerpt :There is an increasing interest in minimizing the blood loss associated with TKA in order to reduce the incidence of symptomatic post-surgical anemia and the need for ABT. In this way, several treatments have been evaluated with different degree of success [7–22]. Tranexamic acid (TXA) and fibrin sealants are the two that have demonstrated its efficacy more consistently in several clinical trials and TXA has been adopted as standard treatment by many surgeons [23].
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.09.002.