Rational application of tranexamic acid and drainage tube in total knee arthroplasty

doi:10.3969/j.issn.2095-4344.0340

Abstract

Abstract:

BACKGROUND: Currently, large amount of blood loss after total knee arthroplasty (TKA) is an issue of concern in clinic, and tranexamic acid administrated by various ways is used to reduce postoperative blood loss. Drainage tubes are commonly placed postoperatively; however, there are no confirmed assessments on the local application of tranexamic acid without drainage tube placement.

OBJECTIVE: To observe the effects of topical application of tranexamic acid on the blood loss after TKA, and to explore the reasonable application method of drainage tube.

METHODS: Ninety patients with unilateral TKA were randomly divided into three groups. The patients in group A received the intraarticular injection normal saline (50 mL), drainage tube was placed postoperatively, and closed for 4 hours; group B: the mixture of 50 mL of normal saline and 1.6 g of tranexamic acid was injected into the articular cavity, drainage tube was placed and closed for 4 hours; group C: the mixture of 50 mL of normal saline and 1.6 g tranexamic acid was injected into the articular cavity without drainage tube placed. The intraoperative blood loss was recorded. In the first two days postoperatively, the hemoglobin, drainage volume, blood transfusion volume and the number of blood transfusion were recorded daily. The total blood loss and hidden blood loss were calculated. The number of deep vein thrombosis of the lower extremity was recorded at 7 days postoperatively. All patients were followed up.

RESULTS AND CONCLUSION: (1) The baseline data and intraoperative blood loss showed no significant differences among groups (P > 0.05). (2) The postoperative total blood loss and the number blood transfusion in the groups B and C were significantly less than those in the group A (P < 0.05), while the differences between groups B and C had no significance (P > 0.05). (3) The drainage volume in the group B was significantly less than that in the group A (P < 0.05). (4) The hidden blood loss did not differ significantly among groups (P > 0.05). (5) None of deep venous thrombosis was observed. (6) These results suggest that topical application of tranexamic acid after TKA can significantly reduce the drainage volume and total blood loss, and can decrease the rate of blood transfusion, but cannot significantly reduce the hidden blood loss, nor will it increase the incidence of deep venous thrombosis. With topical application of tranexamic acid, the drainage tube placement is not needed, so the method is simple, safe and effective.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Arthroplasty, eplacement, nee, ranexamic Acid, lood Loss, urgical, Venous Thrombosis

CLC Number:

R318

Zhang Li-qing, Wei Kai-bin, Zhu Ben-ke, Wang Qiang, Li Chun-pu. Rational application of tranexamic acid and drainage tube in total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(27): 4282-4287.

Figures/Tables 2

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