Ali Torkaman1, Amir Rostami2, Mohammad Reza Sarshar3, Hossein Akbari Aghdam4,5, Paniz Motaghi6, Hamidreza Yazdi7. 1. epartment of Knee Surgery, Firouzgar Hospital, Iran University of Medical Sciences,Tehran , Iran. 2. Bone and Joint Reconstruction Research Center, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran. 3. Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran. 4. Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences , Isfahan, Iran. 5. Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran. 6. Iran University of Medical Sciences, Tehran, Iran. 7. Bone and Joint Reconstruction Research Center, Firouzgar Hospital, Iran University of edical ciences, Tehran, Iran.
Abstract
BACKGROUND: Blood loss during and immediately after total knee arthroplasty (TKA) is among the most challenging concerns. It has been demonstrated that Tranexamic acid (TXA) can help to reduce perioperative blood loss. TXA can be used as an oral, topical or intravenous injection. Many studies evaluated the effectiveness of each route of administration but few works on a comparison between them. The current study aimed to compare the effectiveness of intravenous injection versus topical use of TXA in reducing perioperative blood loss after primary total knee arthroplasty. METHODS: Eighty-five patients who were a candidate for total knee arthroplasty were randomized into two groups: one group received Intravenous injection of 15 mg/kg TXA, 10 min before tourniquet inflation while the other group received 1 g diluted TXA during wound closure. The postoperative blood loss was estimated by measuring the whole drain output and also hemoglobin (HB) drops. Both groups compared based on the need for allogenic blood transfusion and also thromboembolic events. RESULTS: Patients who received topical TXA had a higher total drain output (p <0.0001) compared to intravenous injection. The hemoglobin drop also was more in the topical group although it was marginally significant (p =0.05). CONCLUSION: Intravenous injection of TXA is more effective in reducing postoperative blood loss after primary TKA compared to topical administration.
BACKGROUND: Blood loss during and immediately after total knee arthroplasty (TKA) is among the most challenging concerns. It has been demonstrated that Tranexamic acid (TXA) can help to reduce perioperative blood loss. TXA can be used as an oral, topical or intravenous injection. Many studies evaluated the effectiveness of each route of administration but few works on a comparison between them. The current study aimed to compare the effectiveness of intravenous injection versus topical use of TXA in reducing perioperative blood loss after primary total knee arthroplasty. METHODS: Eighty-five patients who were a candidate for total knee arthroplasty were randomized into two groups: one group received Intravenous injection of 15 mg/kg TXA, 10 min before tourniquet inflation while the other group received 1 g diluted TXA during wound closure. The postoperative blood loss was estimated by measuring the whole drain output and also hemoglobin (HB) drops. Both groups compared based on the need for allogenic blood transfusion and also thromboembolic events. RESULTS: Patients who received topical TXA had a higher total drain output (p <0.0001) compared to intravenous injection. The hemoglobin drop also was more in the topical group although it was marginally significant (p =0.05). CONCLUSION: Intravenous injection of TXA is more effective in reducing postoperative blood loss after primary TKA compared to topical administration.
Entities:
Keywords:
Blood loss; Intravenous; Topical; Total knee arthroplasty; Tranexamic acid
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