Risk of Deep Venous Thrombosis in Drain Clamping With Tranexamic Acid and Carbazochrome Sodium Sulfonate Hydrate in Total Knee Arthroplasty

Onodera, Tomohiro; Majima, Tokifumi; Sawaguchi, Naohiro; Kasahara, Yasuhiko; Ishigaki, Takayuki; Minami, Akio

doi:10.1016/j.arth.2011.02.004

Cited by 56 publications

(46 citation statements)

References 15 publications

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“…All participants in the assessed studies received routine prophylactic antithrombotic therapy. Previous studies have reported that there is a higher risk of developing DVT and PE when TXA is used, possibly because antifibrinolytic agents theoretically increase the risk of clotting. However, in the present analysis, we found no significant differences in incidence of DVT or PE between groups.…”

Section: Discussioncontrasting

confidence: 96%

Efficiency and Safety of Intravenous Tranexamic Acid in Simultaneous Bilateral Total Knee Arthroplasty: A Systematic Review and Meta‐analysis

Xuan

2016

Orthopaedic Surgery

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The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of i.v. tranexamic acid (TXA) in simultaneous bilateral total knee arthroplasty (TKA). Potentially relevant published reports were identified from the following electronic databases: Medline, PubMed, Embase, ScienceDirect and Cochrane Library. RevMan v5.3was used to pool data. Two randomized controlled trials and four case-control studies met the inclusion criteria. The current meta-analysis identified significant differences between TXA group and control groups in terms of postoperative hemoglobin concentration (P < 0.01), drainage volume (P < 0.01), transfusion rate (P < 0.01) and units transfused (P = 0.006). There were no significant differences in length of stay (P = 0.66), operation time (P = 0.81) or and incidence of adverse effects such as infection (P = 0.42), deep venous thrombosis (DVT) (P = 0.88) and pulmonary embolism (PE) (P = 0.11). Our results show that i.v. administration of TXA in simultaneous bilateral TKA reduces postoperative drops in hemoglobin concentration, drainage volume, and transfusion requirements and does not prolong length of stay or operation time. Moreover, no adverse effects, such as infection, DVT or PE, were associated with TXA.

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Section: Discussioncontrasting

confidence: 96%

Efficiency and Safety of Intravenous Tranexamic Acid in Simultaneous Bilateral Total Knee Arthroplasty: A Systematic Review and Meta‐analysis

Xuan

2016

Orthopaedic Surgery

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“…Random sequence generation, allocation concealment, blinding of participants, personnel, and outcome assessors are appropriate in 4 studies. [11,19–21] Three studies did not report incomplete outcomes data. [11,20,21] The NOS was used to assess the quality of the non-RCTs, and the results can be seen in Table 3.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of tranexamic acid plus drain-clamping to reduce blood loss in total knee arthroplasty

Zhang¹,

Zhang²,

Wang³

2017

Medicine

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Background:Perioperative blood loss is still an unsolved problem in total knee arthroplasty (TKA). The efficacy of the preoperative use of tranexamic acid (TXA) plus drain-clamping to reduce blood loss in TKA has been debated. This meta-analysis aimed to illustrate the efficacy of TXA plus drain-clamping to reduce blood loss in patients who underwent a TKA.Methods:In February 2017, a systematic computer-based search was conducted in PubMed, EMBASE, Web of Science, the Cochrane Database of Systematic Reviews, and Google Scholar. Data from patients prepared for TKA in studies that compared TXA plus drain-clamping versus TXA alone, drain-clamping alone, or controls were retrieved. The primary endpoint was the need for transfusion. The secondary outcomes were total blood loss, blood loss in drainage, the decrease in hemoglobin, and the occurrence of deep venous thrombosis. After testing for publication bias and heterogeneity between studies, data were aggregated for random-effects models when necessary.Results:Ultimately, 5 clinical studies with 618 patients (TXA plus drain-clamping group = 249, control group = 130, TXA-alone group = 60, and drain-clamping group = 179) were included. TXA plus drain-clamping could decrease the need for transfusion, total blood loss, blood loss in drainage, and the decrease in hemoglobin than could the control group, the TXA-alone group, and the drain-clamping group (P < .05). There was no significant difference between the occurrence of deep venous thrombosis between the included groups (P > .05).Conclusions:TXA plus drain-clamping can achieve the maximum effects of hemostasis in patients prepared for primary TKA. Because the number and the quality of the included studies were limited, more high-quality randomized controlled trials are needed to identify the optimal dose of TXA and the clamping hours in patients prepared for TKA.

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“…Two more small studies were published in 2011, also showing reduced postoperative bleeding, but again not commenting on changes in rates of transfusions. 22, 23 Another study in 2012 was performed by Mutsuzaki et al 24 in which they showed that total blood loss, total drainage, mean transfusion volume, and transfustion rates were all lower when TXA was injected through the drain after TKA and the drain then clamped, as compared with not injecting TXA. A problem with the interpretation of their data, however, is that they routinely used autotransfusion from preoperative autologous donation.…”

Section: Discussionmentioning

confidence: 99%

Topical Tranexamic Acid Reduces Blood Loss and Transfusion Rates in Total Hip and Total Knee Arthroplasty

König

Hamlin

Waters

2013

The Journal of Arthroplasty

177

151

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The objective of this study was to determine if tranexamic acid (TXA) applied topically reduced postoperative bleeding and transfusion rates after primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). Two hundred and ninety consecutive patients from a single surgeon were enrolled. In TKA, TXA solution was injected into the knee after closure of the arthrotomy. In THA, the joint was bathed in TXA solution at three points during the procedure. In both THA and TKA the TXA solution was at a concentration of 3gm TXA per 100mL saline. The mean blood loss was significantly higher in the non-TXA patients in both TKA and THA groups. Postoperative transfusions decreased dramatically with TXA, dropping from 10% to 0%, and from 15% to 1%, in the TKA and THA groups, respectively. Topical application of TXA significantly reduces postoperative blood loss and transfusion risk in TKA and THA.

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Risk of Deep Venous Thrombosis in Drain Clamping With Tranexamic Acid and Carbazochrome Sodium Sulfonate Hydrate in Total Knee Arthroplasty

Cited by 56 publications

References 15 publications

Efficiency and Safety of Intravenous Tranexamic Acid in Simultaneous Bilateral Total Knee Arthroplasty: A Systematic Review and Meta‐analysis

Efficiency and Safety of Intravenous Tranexamic Acid in Simultaneous Bilateral Total Knee Arthroplasty: A Systematic Review and Meta‐analysis

Efficacy of tranexamic acid plus drain-clamping to reduce blood loss in total knee arthroplasty

Topical Tranexamic Acid Reduces Blood Loss and Transfusion Rates in Total Hip and Total Knee Arthroplasty

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