Tranexamic acid is effective for blood management in open-wedge high tibial osteotomy

Kim, Kang‐Il; Kim, Hwan Jin; Kim, Jun Seok; Bae, Seong Hae

doi:10.1016/j.otsr.2018.07.019

Cited by 36 publications

(84 citation statements)

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“…It has achieved good results in TKA and total hip arthroplasty (THA). However, few studies have been conducted on the role of TXA in HTO, and most of the research has only concentrated on the effects of intravenous or topical application alone on blood loss. The aim of the present study was to explore the efficacy and safety of the combined administration of TXA after HTO.…”

Section: Discussionmentioning

confidence: 99%

“…Through a retrospective study of 66 HTO patients, Palanisamy et al found that intravenous administration 10 minutes before application of the tourniquet and intravenous administration of TXA 3 h after the operation could reduce blood loss. In another retrospective study, Kim et al injected TXA at a dose of 10 mg/kg before and 6 h after tourniquet application and 24 h after the operation. The results showed that the hemoglobin level in the TXA group was higher than that in the control group 1, 2 and 5 days after the operation ( P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Palanisamy et al did not observe symptomatic DVT in 66 patients with HTO who underwent intravenous TXA administration during the perioperative period. Kim et al performed CT venography 5 days after surgery in 75 patients with TXA, and no DVT was found. In our study, there was no significant difference in the postoperative coagulation parameters between the combined group and the solo group and no patient had symptomatic DVT.…”

Section: Discussionmentioning

confidence: 99%

“…It can reduce the perioperative loss of blood and the transfusion rate, while it does not increase the risk of complications such as deep venous thrombosis (DVT). However, its application in HTO has been rarely studied. TXA has many methods of administration, including intravenous, intramuscular, topical and oral administration; among these methods, intravenous and topical administration, are commonly used in orthopaedics.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is considered that the topical application of TXA in HTO can reduce the amount of blood loss and the incidence of incision complications. In 2018, Kim et al retrospectively analyzed the effect of intravenous TXA in open wedge HTO. The patients received intravenous medication three times during the perioperative period: before the tourniquet was released, 6 h after the operation, and 24 h after the operation.…”

Section: Introductionmentioning

confidence: 99%

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Intravenous Combined with Topical Tranexamic Acid Administration Has No Additional Benefits Compared with Intravenous Administration Alone in High Tibial Osteotomy: A Retrospective Case‐Control Study

Guo

et al. 2020

Orthopaedic Surgery

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Objective: To investigate whether intravenous combined with topical administration of tranexamic acid (TXA) is superior to intravenous administration alone in terms of blood loss, incision complications, functional recovery, and pain relief in high tibial osteotomy (HTO). Methods:Clinical data of patients with knee osteoarthritis (OA) treated with unilateral HTO were retrospectively reviewed. The patients were grouped according to the TXA administration method, with 24 patients in the combined group and 21 in the solo group. In the combined group, 100 mL saline containing 1 g TXA was intravenously administered before application of a tourniquet, and 20 mL saline containing 2 g TXA was injected through a drainage tube after closure of the incision. Alternatively, 100 mL of saline containing 1 g TXA was intravenously administered before application of a tourniquet in the solo group. The blood loss and adverse events were compared between the two groups.Results: All patients were followed for more than half a year. The drainage volume on the first day and total blood loss on the second day after surgery in the combined and single treatment groups were 130.06 AE 29.22 and 165.35 AE 43.08 mL (P < 0.05), respectively, and 327.17 AE 64.26 and 385.45 AE 63.31 mL (P < 0.05). There were no blood transfusions in either group. One case of delayed incision healing was observed in the solo group, and no such event occurred in the combined group. There were no significant differences between the two groups in terms of the following factors: the activated partial thromboplastin time (APTT) and prothrombin time (PT); levels of fibrinogen (FIB) and D-dimer on the second day after surgery; numbers of hospitalization days and thromboembolism events; and knee joint function and visual analog score 6 months after surgery.Conclusion: Intravenous combined with topical TXA administration in HTO is superior to intravenous administration alone for reducing postoperative blood loss and drainage volume without thromboembolic complications. However, even with only intravenous TXA administration, no cases of blood transfusion and only 1 case of incision complication occurred. At the same time, the combined use of TXA did not improve the recovery of knee joint function and pain relief after HTO.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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