Application of perioperative pulse irrigation combined with tranexamic acid in total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2904

Abstract

Abstract:

BACKGROUND: Perioperative blood loss in total knee arthroplasty can affect the quick recovery of patients.

Many studies have proved that tranexamic acid can reduce perioperative blood loss in total knee arthroplasty, but there is still controversy and no unified view.

OBJECTIVE: To investigate the effect of pulse irrigation combined with topical use of tranexamic acid on perioperative blood loss, inflammatory response and complications in total knee arthroplasty.

METHODS: Totally 63 patients with unilateral knee osteoarthritis including 19 males and 44 females, aged 60 to 75 years, who were treated in the Huaian First Hospital Affiliated to Nanjing Medical University from August 2018 to December 2019, were selected. The patients were randomly divided into two groups according to the envelope balloting method. In the experimental group, 32 patients received intraoperative pulse irrigation combined with topical use of tranexamic acid in the total knee arthroplasty. In the control group, 31 patients received conventional irrigation combined with topical use of tranexamic acid in the total knee arthroplasty. Total perioperative blood loss and hidden blood loss were calculated, and the number of transfusions and blood transfusion volume were recorded. Serum inflammatory factors and coagulation function were detected 1 and 7 days postoperatively. Color ultrasonography was performed to check deep venous thrombosis in the lower extremities on day 7 after surgery. The research plan was approved by the Ethics Committee of Huaian First Hospital Affiliated to Nanjing Medical University.

RESULTS AND CONCLUSION: (1) Total perioperative blood loss, hidden blood loss and transfusion rate of the experimental group were lower than those of the control group (P < 0.05). (2) At 1 and 7 days after the operation, c-reactive protein, tumor necrosis factor-α and interleukin-6 in the experimental group were lower than those in the control group (P < 0.05). (3) There was no significant difference in prothrombin time, activated partial thrombin time and international standardized ratio between the two groups (P > 0.05). (4) There was no deep vein thrombosis in the two groups. (5) The results have shown that compared with conventional irrigation combined with topical use of tranexamic acid, pulse irrigation combined with topical use of tranexamic acid could significantly reduce total and hidden blood loss in the perioperative period of total knee arthroplasty, reduce the blood transfusion rate, and reduce the inflammatory response after knee arthroplasty.

Key words: bone, joint replacement, prosthesis, implant, tranexamic acid, pulse, hemostasis, arthritis

CLC Number:

Zhou Zhi, Xiong Yaqiong. Application of perioperative pulse irrigation combined with tranexamic acid in total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(36): 5806-5811.

Figures/Tables 6

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