Efficacy and safety of tranexamic acid on blood loss after unilateral total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2015.17.006

Abstract

Abstract:

BACKGROUND: Total knee arthroplasty is always associated with peripheral blood loss. Blood transfusion not only involves additional cost and prolongs rehabilitation time, but also carries substantial risk of immunologic reaction and disease transmission. Therefore it is very important to reduce blood loss of total knee arthroplasty.

OBJECTIVE: To investigate the efficacy and safety of tranexamic acid on reducing blood loss after total knee arthroplasty.

METHODS: We enrolled 64 patients with primary osteoarthritis undergoing a unilateral total knee arthroplasty and randomized them into two groups, with 32 patients in each group. Tranexamic acid group: patients received intravenous drop infusion of tranexamic acid dissolved in 250 mL normal saline (10 mg/kg) at 15 minutes before operation; control group: patients just received 250 mL normal saline. Intraoperative blood loss, postoperative blood loss, postoperative hemoglobin levels, amount of blood transfusion, and number of patients requiring blood transfusion were compared. Fibrinogen, prothrombin time and other coagulation indicators were also examined before operation and 3 hours after operation. Deep vein thrombosis in both limbs of all patients was examined by the color Doppler ultrasonography 30 days after operation.

RESULTS AND CONCLUSION: There was no significant difference in intraoperative blood loss between the two groups (P > 0.05). Postoperative volume of blood loss was lower in the tranexamic acid group than in the control group (P < 0.001). The amount of blood transfusion and number of patients requiring blood transfusion were lower in the tranexamic acid group than in the control group (P < 0.001). The postoperative hemoglobin levels were obviously higher in the tranexamic acid group than in the control group (P < 0.001). There was no significant difference in coagulation indicators between two groups at postoperative 3 hours, but D-dimer value in the two groups was significantly higher than that before surgery, and the tranexamic acid group was lower than the control group (P < 0.001). No cases appeared deep vein thrombosis after operation. Experimental findings indicate that, tranexamic acid can effectively reduce postoperative blood loss and blood transfusion, as well as number of blood transfusions after total knee arthroplasty. And it did not increase the risk of deep vein thrombosis.

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

全文链接：

Key words: Arthroplasty, Replacement, Knee, Tranexamic Acid, Blood Loss, Surgical, Venous Thrombosis

CLC Number:

R318

Min Peng, Peng Yin-xiao, Hu Jiang-hai, Gu Zu-chao . Efficacy and safety of tranexamic acid on blood loss after unilateral total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(17): 2655-2660.

Figures/Tables 5

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