A comparative, retrospective study of peri-articular and intra-articular injection of tranexamic acid for the management of postoperative blood loss after total knee arthroplasty

Mao, Zhenyang; Yue, Bing; Wang, You; Yan, Mi; Dai, Kerong

doi:10.1186/s12891-016-1293-3

Cited by 30 publications

(62 citation statements)

References 32 publications

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“…Not only can reduce blood loss, but also which can inhibit plasmin and lower in ammation. Therefore, in this study every patient administered intravenously TXA [16,8].…”

Section: Discussionmentioning

confidence: 99%

After Total Knee Arthroplasty Different Knee Position Bring Distinct Effects-a Prospective Study of One Hundred Patients

Zheng¹,

Liu²,

Zhang³

2021

Preprint

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Background Following total knee arthroplasty (TKA) blood loss is a major factor influencing functional recovery and quality of life in patients. The aim of this study was to determine the effect of postoperative leg position on blood loss and functional recovery after TKA.Methods One hundred consecutive patients were enrolled in this prospective randomized study, which with degenerative osteoarthritis of the knee. An equal number of patients were randomly allocated to either flexion or extension groups. In the flexion group, the affected leg was elevated 45° at the hip and with 45° of flexion at the knee, while patients in the extension group had the knee extended fully. Primary outcomes were calculated total blood loss (CBL), hidden blood loss(HBL), intraoperative blood loss(IBL),haemoglobin(HB) level and haematocrit(HCT).Results CBL, HBL, postoperative levels of HB and HCT, drop level of HB and HCT between the two groups after 72 hours were significantly different, with patients in the flexion group experiencing lower blood loss than those in the extension group (P < 0.05).However, there no difference between groups in the postoperative levels of HB and HCT, drop level of HB and HCT at 24 hours. Even though after 1 week range of motion (ROM) was statistical difference in groups, but after 6-week rehabilitation, patients from both groups attained a similar ROM in the knee. Conclusions The results of this study definite that after TKA execute the protocol，maintaining a position with the hip 45°flexion and the knee flexed at 45° prolong 48 hours, is an effective method for reducing blood loss and increasing functional ROM.

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“…Not only can reduce blood loss, but also which can inhibit plasmin and lower in ammation. Therefore, in this study every patient administered intravenously TXA [16,8].…”

Section: Discussionmentioning

confidence: 99%

After Total Knee Arthroplasty Different Knee Position Bring Distinct Effects-a Prospective Study of One Hundred Patients

Zheng¹,

Liu²,

Zhang³

2021

Preprint

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“…previously cement was placed between the bone-cutting site and implant component to reduce bone oozing, and IAI of TXA was employed to reduce blood oozing after synovectomy. However, muscle oozing was not effectively managed using this approach, and the studies on IMI of TXA in unilateral TKA are limited [13][14][15]. Mao et al.…”

Section: Discussionmentioning

confidence: 99%

“…Mao et al. demonstrated that IMI and IAI of TXA e ciently at reducing blood loss during TKA compared with a control group; but the difference between IMI and IAI was nonsigni cant [13]. Pinsornsak et al reported that the antibleeding effects of intramuscular injected and intravenous injected TXA were similar [14].…”

Section: Discussionmentioning

confidence: 99%

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Significantly Reducing Blood Loss Using Intra-muscular Injection of Tranexamic Acid during Total Knee Arthroplasty

Lin¹,

Tsai²,

Wu³

et al. 2020

Preprint

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Background Administration of an intra-muscular injection (IMI) of tranexamic acid (TXA) had been demonstrated to be effective in reducing both blood loss and the transfusion rate during total knee arthroplasty (TKA). However, few studies have reported on the efficiency of IMI of TXA. We studied the efficiency of IMI of TXA to reduce blood loss during TKA. Methods In this prospective study, 50 patients undergoing primary simultaneous bilateral TKA were enrolled. The right knee received a IMI of 1 g of TXA (Group I), and the left knee received an intra-articular injection (IAI) of 1 g of TXA (Group II). The clinical outcome measures were a change in hemoglobin levels, blood loss from Hemovac, and number of allogeneic blood units. Results Compared with Group II, the decrease in blood loss from Hemovac was significantly less for Group I (460.1 ± 36.79 vs. 576.0 ± 34.01, P < 0.001), and no significant difference in surgical times was observed. Conclusions IMI of TXA can significantly reduce blood loss than IAI of TXA during TKA without increased complications such as surgical site infection, poor wound healing, skin necrosis, pulmonary embolism, and deep vein thrombosis.

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“…However, patients with chronic kidney disease (CKD) have been reported to carry higher risks of cardiovascular disease, increased blood transfusion and postoperative infection, and acute kidney disease (AKD) after TKA [ 3 ]. The estimated blood loss after TKA ranges from 1000 to 1400 ml and results in a blood transfusion rate of 0–17.5% [ 4 – 7 ]. Anemia-related AKD via a hypotension episode or a decrease in oxygen-carrying capacity has been reported [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

The Incidence and Risk Factors of Acute Kidney Disease after Total Knee Arthroplasty with Early Postoperative Volume Supplement

Chen

Chen³

et al. 2018

BioMed Research International

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Background Etiology of acute kidney disease (AKD) after total knee arthroplasty (TKA) was considered as multifactorial. However, the role of early postoperative volume supplement in AKD rate has not been investigated. The purpose of this study was to evaluate the incidence and risk factors of AKD in patients with early volume supplement following TKA. Methods This was a retrospective study with 458 patients who underwent unilateral TKA. All the patients received 6% tetrastarch, 7.5ml/kg, early in the postoperative period. Postoperative AKD was defined as the postoperative creatinine level ≥ 1.5 times compared with preoperative data. Potential variables associated with AKD were analyzed by multivariate logistic regression model to identify the AKD risk factors in TKA patients after early postoperative volume supplement. Results The AKD rate was 3.3% (15 patients) in all patients. Age (OR = 1.09; P = .031) and coronary artery disease (CAD) (OR = 3.63; P = .034) were associated with increased risk of development of postoperative AKD. Other comorbidities as hypertension, diabetes, and CKD were not statistically significant risk factors. Conclusion Our study demonstrated that age and CAD were independent risk factors of AKD in TKA patients. However, the common risk factors as hypertension, diabetes, and CKD were not significantly associated with AKD after TKA if early postoperative supplement of tetrastarch is administered.

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A comparative, retrospective study of peri-articular and intra-articular injection of tranexamic acid for the management of postoperative blood loss after total knee arthroplasty

Cited by 30 publications

References 32 publications

After Total Knee Arthroplasty Different Knee Position Bring Distinct Effects-a Prospective Study of One Hundred Patients

After Total Knee Arthroplasty Different Knee Position Bring Distinct Effects-a Prospective Study of One Hundred Patients

Significantly Reducing Blood Loss Using Intra-muscular Injection of Tranexamic Acid during Total Knee Arthroplasty

The Incidence and Risk Factors of Acute Kidney Disease after Total Knee Arthroplasty with Early Postoperative Volume Supplement

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