Application of tranexamic acid combined with tourniquet optimization program in total knee arthroplasty

doi:10.3969/j.issn.2095-4344.2931

Abstract

Abstract:

BACKGROUND: The use of tourniquets during knee replacements has received widespread attention and controversy in recent years. Recently, some scholars have proposed an optimized application plan of tourniquet during operation, which is conducive to speeding up postoperative recovery of patients.

OBJECTIVE: To observe the clinical effect of tranexamic acid combined with tourniquet optimization program

during total knee arthroplasty.

METHODS: Sixty patients with knee osteoarthritis who were admitted to the Traditional Chinese Medicine Hospital of Meishan City from March 2018 to December 2019 were included, including 20 males and 40 females. They were divided into two groups using random number table method (n=30 per group). The observation group received total knee arthroplasty, and a tourniquet was used from implantation of the prosthesis to bone cement hardening (optimization of the tourniquet). The control group received total knee arthroplasty, and the tourniquet was used throughout the treatment. The dosage and method of tranexamic acid in the two groups were the same. Serum hemoglobin, leukocytes, and C-reactive protein levels were detected at 1, 3, and 7 days postoperatively. Visual analogue scale scores were used to assess pain at 1, 3, 7 and 1 month postoperatively. At 3, 7 days and 1 month, the HSS score was used to assess knee function. The trial was approved by the ethics committee of Traditional Chinese Medicine Hospital of Meishan City.

RESULTS AND CONCLUSION: (1) The hemoglobin value of the observation group at 1 day was lower than that of the control group (P < 0.05), and there was no significant difference between the two groups at other time points (P > 0.05). (2) Leukocyte count was lower in the observation group than that of the control group at 3 and 7 days (P < 0.05), and there was no significant difference between the two groups at 1 day after operation (P > 0.05). (3) C-reactive protein level was lower at 1 and 3 days after operation in the observation group than in the control group (P < 0.05), and there was no significant difference between the two groups at 7 days after the operation. (4) The visual analogue scale score at 3 days after surgery in the observation group was lower than that in the control group (P < 0.05), and there was no significant difference at the other two time points between the two groups (P > 0.05). (5) There was no significant difference in HSS scores between the two groups at various time points (P > 0.05). (6) The results showed that the optimal use of tranexamic acid combined with tourniquet can relieve pain and inflammation levels after total knee arthroplasty, which is of great significance for early recovery of the patients.

Key words: bone, implant, prosthesis, joint replacement, tranexamic acid, hemostasis, efficacy, pain, inflammation

CLC Number:

Peng Ruhui, Zhou Dechun. Application of tranexamic acid combined with tourniquet optimization program in total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(36): 5812-5817.

Figures/Tables 10

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