Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (9): 1329-1334.doi: 10.3969/j.issn.2095-4344.2015.09.003

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Primary unilateral cemented total knee arthroplasty: effect of tranexamic acid usage on blood loss

Hou Zhen-yang1, Su Chang-zheng1, Pang Tao1, Lv Dong1, Zhu Biao1, Sun Yi-ling2, Li Zhen1, Chai Xing-yu1, Xu Zheng-wen1   

  1. 1Second Department of Joint Sports Medicine, 2Second Department of Medical Oncology, Tengzhou Central People’s Hospital, Tengzhou 277500, Shandong Province, China
  • Revised:2014-12-22 Online:2015-02-26 Published:2015-02-26
  • Contact: Su Chang-zheng, Associate chief physician, Second Department of Joint Sports Medicine, Tengzhou Central People’s Hospital, Tengzhou 277500, Shandong Province, China
  • About author:Hou Zhen-yang, Master, Physician, Second Department of Joint Sports Medicine, Tengzhou Central People’s Hospital, Tengzhou 277500, Shandong Province, China

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Abstract:

BACKGROUND: Increasing evidence has focused on the application of tranexamic acid to reduce bleeding during total knee arthroplasty, but its usage method remains controversial.
OBJECTIVE: To explore and discuss the effect of tranexamic acid and different usage methods on blood loss in the perioperative period of primary unilateral cemented total knee arthroplasty.
METHODS: Sixty patients who were candidates for unilateral cemented total knee replacement in the Second Department of Joint Sports Medicine, Tengzhou Central People’s Hospital, from January 2013 to June 2014, were included in this study. All patients were randomly divided into three groups. Group A (n=20): patients were injected with 100 mL normal saline through intravenous drip when the operation began, and then with 10 mL normal saline through intra-articular injection after skin closure. Group B (n=20): patients were injected with 10 mg/kg tranexamic acid which was dissolved in 100 mL normal saline when the operation began, and then with 10 mL normal saline through intra-articular injection after skin closure. Group C (n=20): patients were injected with 100 mL normal saline when the operation began, and then with 500 mg tranexamic acid dissolved in 10 mL normal saline through intra-articular injection after skin closure. The dominant blood loss, hidden blood loss, blood transfusion ratio and per capita of each group were compared. Clinical symptoms of pulmonary embolism and lower limb deep vein thrombosis were observed. Doppler ultrasound examine on lower extremity would be performed if necessary.
RESULTS AND CONCLUSION: Dominant and hidden blood loss of patients from groups B and C were significantly lower than that of patients from group A (P < 0.05). Although the dominant blood loss between group B and group C showed no significant difference (P > 0.05), the hidden blood loss in group B was significantly less than that in group C  (P < 0.05). The transfusion population and ratio of patients from groups B and C were significantly lower than that of patients from group A (P < 0.05). In all three groups, no deep vein thrombosis was found at 14 days after operation. Tranexamic acid can largely reduce the dominant and hidden blood loss, as well as blood transfusion ratio and per capita of each group after primary unilateral cemented total artificial knee arthroplasty, without increasing the risk of lower extremity deep vein thrombosis. The use of tranexamic acid injecting through intravenous drip is more effective than the use of intra-articular injection.


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


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

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