Higher doses of topical tranexamic acid safely improves immediate functional outcomes and reduces transfusion requirement in total knee arthroplasty

Wu, Chenghan; Tan, Cheryl

doi:10.1007/s00402-020-03591-4

Cited by 8 publications

(2 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In theory, patients at risk associated with use of IV TXA may tolerate topical administration without increased risk of systemic adverse events due to the presumed delay in systemic absorption [11]. Compared with IV TXA, intra-articular (IA) application of TXA as a topical injection has shown similar efficacy in reducing both blood loss and transfusion rate in primary TKA [13][14][15]. However, the methods of topical administration of TXA are variable and somewhat complicated [11,13,16,17].…”

Section: Introductionmentioning

confidence: 99%

Tranexamic acid in a periarticular multimodal cocktail injection for blood management in total knee arthroplasty: a prospective randomized study

Kim

Bae

Kim

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Background This study aimed to assess the efficacy of tranexamic acid (TXA) mixed in a periarticular multimodal cocktail (PAMC) as a topical administration and to determine whether combined use of intravenous and topical administration is more effective than a single administration of TXA. Methods A total of 240 patients who underwent primary total knee arthroplasty (TKA) was enrolled for this prospective randomized controlled study. Patients were divided into three groups of 80 patients each. Baseline data were comparable for all groups. Average follow-up was 18.7 months. Group 1 consisted of patients who received intravenous (IV) TXA, Group 2 patients were those who received TXA in a PAMC injection for topical administration, and Group 3 consisted of patients who received a combination of both intravenous and topical administration of TXA. Primary outcomes were postoperative hemoglobin drop and amount of suction drainage. Secondary outcomes were estimated blood loss (EBL), postoperative transfusion rate, and complications. Results The mean postoperative hemoglobin drop was significantly lower in Group 3 (2.13 ± 0.77 g/dL, p=0.004), and there was no difference between Group 1 and Group 2 (2.56 ± 1.07 g/dL vs 2.55 ± 0.86 g/dL, p=0.999). The mean drainage amount was significantly lower in Group 3 (326.58 ± 57.55 ml, p<0.001), and there was no difference between Group 1 and Group 2 (367.93 ± 87.26 ml vs 397.66 ± 104.10 ml, p=0.072). Similarly, the mean EBL was significantly lower in Group 3 (p=0.003), and there was no significant difference between Group 1 and Group 2 (p=0.992). There were no significant differences in requirement for postoperative transfusion rate or incidence of complications among the three groups. Conclusion TXA mixed in a PAMC injection showed a similar effect to IV administration of TXA following TKA. Furthermore, combined use of both IV and PAMC injection provided better perioperative bleeding control with similar safety in patients without relevant comorbidities. Trial registration WHO ICTRP identifier KCT0005703. Retrospectively registered: 12/24/2020

show abstract

Section: Introductionmentioning

confidence: 99%

Tranexamic acid in a periarticular multimodal cocktail injection for blood management in total knee arthroplasty: a prospective randomized study

Kim

Bae

Kim

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…TXA is a lysine derivative 10 that can be inhaled, applied topically, or given by intravenous (IV) administration 3,11 in order to systemically manage patient hemorrhage. Depending on the specific case, dosing recommendations have ranged from administering TXA at a dose of 15 mg/kg of body weight 12 to administering a bolus ranging from 1 to 4 g of TXA 13,14 . Some studies have experimented with providing multiple doses of TXA but have generally found similar outcomes between single and multiple-dose groups 15 .…”

mentioning

confidence: 99%

The Efficacy and Safety of Tranexamic Acid Treatment in Orthopaedic Trauma Surgery

et al. 2021

View full text Add to dashboard Cite

show abstract

Is there a role of tranexamic acid in rheumatoid arthritis with total knee arthroplasty? Findings from a multicenter prospective cohort study in China

Lei

Xie

Huang

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Higher doses of topical tranexamic acid safely improves immediate functional outcomes and reduces transfusion requirement in total knee arthroplasty

Cited by 8 publications

References 17 publications

Tranexamic acid in a periarticular multimodal cocktail injection for blood management in total knee arthroplasty: a prospective randomized study

Tranexamic acid in a periarticular multimodal cocktail injection for blood management in total knee arthroplasty: a prospective randomized study

The Efficacy and Safety of Tranexamic Acid Treatment in Orthopaedic Trauma Surgery

Is there a role of tranexamic acid in rheumatoid arthritis with total knee arthroplasty? Findings from a multicenter prospective cohort study in China

Contact Info

Product

Resources

About