Intravenous Tranexamic Acid Has Benefit for Reducing Blood Loss after Open-Wedge High Tibial Osteotomy: A Randomized Controlled Trial

Kim, Man Soo; Koh, In-Jun; Sung, Yong-Gyu; Park, Dong-Chul; Ha, W. Jung; In, Yong

doi:10.3390/jcm10153272

Cited by 6 publications

(31 citation statements)

References 41 publications

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“…The efficacy of TXA administration in reducing the amount of perioperative blood loss has been well established in various orthopedic procedures such as joint arthroplasty and spine surgery [13,14]. There have been several studies examining the efficacy and safety of TXA administration in knee osteotomies [10,15,27]. Kim et al demonstrated that the administration of TXA reduced total estimated blood loss and total amount of drainage after MOWHTO [9].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, a number of randomized controlled studies have revealed the effectiveness of TXA in reducing perioperative blood loss in patients undergoing total joint arthroplasty [13,14], and a consensus has been reached regarding its efficacy in this patient population. By contrast, there have only been two randomized controlled trials dealing with this subject in osteotomies around the knee [10,15]. Consequently, clinical evidence validating routine TXA administrations in knee osteotomies is still not robust enough.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Iseki

Kanto

et al. 2023

J Orthop Surg Res

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Background This randomized controlled study was undertaken to investigate the efficacy of intravenous tranexamic acid (TXA) administration in reducing perioperative blood loss in patients undergoing medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO). It was hypothesized that TXA would reduce perioperative blood loss in MOWDTO. Methods A total of 61 knees in 59 patients who underwent MOWDTO during the study period were randomly assigned to either of the groups with intravenous TXA administration (TXA group) or without TXA administration (control group). In the TXA group, patients received 1000 mg of TXA intravenously before skin incision and 6 h after the first dose. The primary outcomes was the volume of perioperative total blood loss which calculated using the blood volume and hemoglobin (Hb) drop. The Hb drop was calculated as the difference between preoperative Hb and postoperative Hb at days 1, 3, and 7. Results The perioperative total blood loss was significantly lower in the TXA group (543 ± 219 ml vs. 880 ± 268 ml, P < 0.001). The Hb drop was significantly lower at postoperative days 1, 3 and 7 in the TXA group than in the control group (day 1: 1.28 ± 0.68 g/dl vs. 1.91 ± 0.69 g/dl, P = 0.001; day 3: 1.54 ± 0.66 g/dl vs. 2.69 ± 1.00 g/dl, P < 0.001; day 7: 1.74 ± 0.66 g/dl vs. 2.83 ± 0.91 g/dl, P < 0.001). Conclusion Intravenous TXA administration in MOWDTO could reduce the perioperative blood loss. Trial registration The study was approved by the institutional review board. (Registered on 26/02/2019 Registration Number 3136). Level of Evidence Level I, randomized controlled trial.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Iseki

Kanto

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…The e cacy of TXA administration in reducing the amount of perioperative blood loss has been well established in various orthopaedic procedures such as joint arthroplasty and spine surgery [13,14]. There have been several studies examining the e cacy and safety of TXA administration in knee osteotomies [10,15,27]. Kim et al demonstrated that the administration of TXA reduced total estimated blood loss and total amount of drainage after MOWHTO [9].…”

Section: Discussionmentioning

confidence: 99%

“…By contrast,there have only been two randomized controlled trials dealing with this subject in osteotomies around the knee [10,15]. Consequently, clinical evidence validating routine TXA administrations in knee osteotomies is still not robust enough.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of intravenous tranexamic acid administration in medial opening wedge distal tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Iseki

Kanto

et al. 2022

Preprint

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Background: This randomized controlled study was undertaken to investigate the efficacy of intravenous tranexamic acid (TXA) administration in reducing perioperative blood loss in patients undergoing medial open-wedge distal tibial tuberosity osteotomy (MOWDTO). It was hypothesized that TXA would reduce perioperative blood loss in MOWDTO. Methods: A total of 61 knees in 59 patients who underwent MOWDTO during the study period were randomly assigned to either of the groups with intravenous TXA administration (TXA group) or without TXA administration (Control group). In the TXA group, patients received 1000 mg of TXA intravenously before skin incision and 6 hours after the first dose. The primary outcomes was the volume of perioperative total blood loss which calculated using the blood volume and hemoglobin (Hb) drop. The Hb drop was calculated as the difference between preoperative Hb and postoperative Hb at day1,3,and 7. Results: The perioperative total blood loss was significantly lower in the TXA group (543±219 ml vs 880±268 ml, P < 0.001). The Hb drop were significantly lower at postoperative days 1, 3 and 7 in the TXA group than in the control group (Day 1: 1.28 ± 0.68 g/dl vs 1.91 ± 0.69 g/dl, P = 0.001; Day 3: 1.54 ± 0.66 g/dl vs 2.69 ± 1.00 g/dl, P < 0.001; Day 7: 1.74 ± 0.66 g/dl vs 2.83 ± 0.91 g/dl, P < 0.001). Conclusion: Intravenous TXA administration in MOWDTO could reduce the perioperative blood loss. Trial registration: The study was approved by the institutional review board. (Registered on 26/02/2019 Registration Number 3136). Level of Evidence: Level I, randomized controlled trial.

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“…Extensive soft tissue release and exposed osteotomy surface in MOWHTO can result in substantial perioperative bleeding, mean total blood loss ranged from 635.0 to 882.7 mL. [16][17][18][19] Many studies have reported TXA administration in the perioperative period of MOWHTO to reduce surgical blood loss. 16,[18][19][20][21][22] Most of the studies adopted intravenous application 18 or combination of intravenous and topical applications, 22,23 and have shown that TXA can reduce surgical blood loss in patients undergoing MOWHTO.…”

Section: Introductionmentioning

confidence: 99%

Topical Use of Low‐dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study

Zheng,

Han,

Zhao

et al. 2024

Orthopaedic Surgery

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ObjectiveMany studies reported that tranexamic acid (TXA) was effective in reducing surgical blood loss in the perioperative period of medial open wedge high tibial osteotomy (MOWHTO). However, few studies focused on the simple topical use of TXA in MOWHTO, and the modality and dosage of topical use of TXA varied. The purpose of this study was to observe the effect of topical use of low‐dose TXA on drainage volume after MOWHTO, and to analyze the related influencing factors.MethodsData of patients who underwent MOWHTO combined with arthroscopic knee surgery in our department from January 2019 to September 2021 were retrospectively analyzed. A total of 105 patients (38 males and 67 females, aged 57.7 ± 7.5 years) were included in this study who received topical TXA or no TXA. The patients were divided into three groups: control group (39 cases), 0.5 g TXA group (40 cases), 1 g TXA group (26 cases). Postoperative drainage volume, wound healing, incidence of hematoma and deep venous thrombosis (DVT) were observed and analyzed in the three groups. The effects of gender, hypertension and diabetes on postoperative drainage volume were analyzed using a t‐test. The correlation between age, body mass index (BMI), osteotomy gap and postoperative drainage volume were analyzed using the Pearson correlation coefficient.ResultsThe average postoperative drainage volume of the control group was 259.54 ± 226.33 mL, that of the 0.5 g TXA group was 277.18 ± 177.68 mL, and that of the 1 g TXA group was 229.15 ± 219.93 mL. There was no statistically significant difference in postoperative drainage volume among the three groups (F = 0.423, p = 0.656). There was no local hematoma and wound infection in the three groups. The wound fat liquefaction was found in one patient of the control group. The incidence of DVT was 38.9% (7/18) and 57.1% (8/14) in the control group and 0.5 TXA group, respectively. There was no significant difference in the incidence of DVT between the above two groups (p = 0.476). The average postoperative drainage volume of male patients in the three groups was higher than that of female patients, and the differences were statistically significant (p < 0.05). There was no correlation between age, BMI, osteotomy gap and postoperative drainage volume in the three groups (p > 0.05).ConclusionTopical use of low‐dose TXA has no significant effect on drainage volume after MOWHTO. The drainage volume after MOWHTO in male patients was more than that in female patients. Topical administration of low‐dose TXA does not increase postoperative complications, such as DVT and hematoma.

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Intravenous Tranexamic Acid Has Benefit for Reducing Blood Loss after Open-Wedge High Tibial Osteotomy: A Randomized Controlled Trial

Cited by 6 publications

References 41 publications

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Efficacy of intravenous tranexamic acid administration in medial opening wedge distal tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Topical Use of Low‐dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study

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