Takuya Iseki1,2, Sachiyuki Tsukada3,4, Motohiro Wakui1, Shinichi Yoshiya2. 1. Department of Orthopaedic Surgery, Nekoyama Miyao Hospital, 14-7 Konan, Chuo-ku, Niigata, Niigata, 950-1151, Japan. 2. Department of Orthopaedic Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya City, Hyogo, 663-8501, Japan. 3. Department of Orthopaedic Surgery, Nekoyama Miyao Hospital, 14-7 Konan, Chuo-ku, Niigata, Niigata, 950-1151, Japan. s8058@nms.ac.jp. 4. Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, Ibaraki, 310-0035, Japan. s8058@nms.ac.jp.
Abstract
PURPOSE: This study was performed to assess the effectiveness of the combined intravenous and intra-articular tranexamic acid (TXA) regimen in total knee arthroplasty (TKA). METHODS: The perioperative blood loss in 75 consecutive patients undergoing unilateral TKA that received both 1000 mg of TXA intravenously and 1000 mg of intra-articular TXA (combined TXA group) was compared with a consecutive series of 77 patients that received 1000 mg of TXA intravenously (intravenous TXA group). An additional 1000 mg of intravenous TXA was administered 6 h after the initial administration in both groups. Neither a pneumatic tourniquet nor drain was used. The primary outcome was the perioperative blood loss at 3 days after TKA calculated using the blood volume and change in haemoglobin from the preoperative value. RESULTS: The perioperative blood loss was significantly lower in the combined TXA group at 3 days after TKA than the intravenous TXA group (686 ± 303 vs. 830 ± 317 mL; 95% CI 44-244 mL; p = 0.0049). The perioperative blood loss was also lower in the combined TXA group at 1 and 7 days after TKA (374 ± 265 vs. 459 ± 226 mL; 95% CI 7-165 mL; p = 0.034 and 751 ± 320 vs. 871 ± 327 mL; 95% CI 16-224 mL; p = 0.024, respectively). No thrombotic events were observed during the study periods. CONCLUSIONS:Combined intra-articular and intravenous TXA regimen significantly reduced perioperative blood loss compared with only intravenous TXA until 7 days after TKA.
RCT Entities:
PURPOSE: This study was performed to assess the effectiveness of the combined intravenous and intra-articulartranexamic acid (TXA) regimen in total knee arthroplasty (TKA). METHODS: The perioperative blood loss in 75 consecutive patients undergoing unilateral TKA that received both 1000 mg of TXA intravenously and 1000 mg of intra-articularTXA (combined TXA group) was compared with a consecutive series of 77 patients that received 1000 mg of TXA intravenously (intravenous TXA group). An additional 1000 mg of intravenous TXA was administered 6 h after the initial administration in both groups. Neither a pneumatic tourniquet nor drain was used. The primary outcome was the perioperative blood loss at 3 days after TKA calculated using the blood volume and change in haemoglobin from the preoperative value. RESULTS: The perioperative blood loss was significantly lower in the combined TXA group at 3 days after TKA than the intravenous TXA group (686 ± 303 vs. 830 ± 317 mL; 95% CI 44-244 mL; p = 0.0049). The perioperative blood loss was also lower in the combined TXA group at 1 and 7 days after TKA (374 ± 265 vs. 459 ± 226 mL; 95% CI 7-165 mL; p = 0.034 and 751 ± 320 vs. 871 ± 327 mL; 95% CI 16-224 mL; p = 0.024, respectively). No thrombotic events were observed during the study periods. CONCLUSIONS: Combined intra-articular and intravenous TXA regimen significantly reduced perioperative blood loss compared with only intravenous TXA until 7 days after TKA.
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