A comparative analysis of the role of Tranexamic acid as an independent variable in reducing intraoperative blood loss in patients undergoing conventional total knee arthroplasty versus computer-assisted total knee arthroplasty

被引：4
作者：
Eachempati K.K. [2 ]
Gurava Reddy A.V. [1 ]
Apsingi S. [2 ]
Sankineani S.R. [1 ]
Shaheed J. [1 ]
Dannana C. [2 ]
机构：
[1] Department of Orthopaedics, Sunshine Hospital, Penderghast Road, Secunderabad
[2] Maxcure Hospital, Behind Cyber Towers, Madhapur, Hyderabad
来源：
MUSCULOSKELETAL SURGERY | 2017年 / 101卷 / 3期
关键词：
Blood loss; CAS; Para-patellar approach; Sub-vastus approach; Tranexamic acid;
D O I：
10.1007/s12306-017-0477-9
中图分类号：
学科分类号：
摘要：
Background: Blood loss in total knee arthroplasty (TKA) is an area of significant concern as it has an effect on patient morbidity and hospital stay. Among many different modalities to reduce blood loss, the use of Tranexamic acid has become a standard procedure nowadays. The aim of our study was to determine if Tranexamic acid alone decreases blood loss as an independent variable irrespective of other blood loss preserving measures. Method: This prospective non-randomized study included patients undergoing unilateral TKA by conventional method (Group 1) and computer-assisted TKA (Group 2). All the patients in both groups received Tranexamic acid in a dose of 10 mg/kg body weight prior to inflation of tourniquet. Blood loss in both the groups was calculated using Nadler’s formula, and haemoglobin (Hb) level was calculated on day one and day three after surgery. Results: The mean drop of Hb in Group 1 was 1.608 and 1.56 g/dl in Group 2 which was statistically significant (p < 0.001); however, none of the patients in either of the groups actually required any blood transfusion postoperatively. Although there was a significant drop in haemoglobin and haematocrit in both the groups, on comparison, there was no significant difference in blood loss and fall in Hb levels between the groups (p > 0.001). Conclusion: Tranexamic acid decreases blood loss in patients undergoing TKA independent of all the other blood conserving procedures. © 2017, Istituto Ortopedico Rizzoli.
引用
收藏
页码：255 / 259
页数：4
相关论文
共 17 条
  • [1] Bierbaum B.E., Callaghan J.J., Galante J.O., Rubash H.E., Tooms R.E., Welch R.B., An analysis of blood management in patients having a total hip or knee arthroplasty, J Bone Joint Surg Am, 81, 1, pp. 2-10, (1999)
  • [2] Vandenbussche E., Duranthon L.D., Couturier M., Pidhorz L., Augereau B., The effect of tourniquet use in total knee arthroplasty, Int Orthop, 26, 5, pp. 306-309, (2002)
  • [3] Tria A.J., Coon T.M., Minimal incision total knee arthroplasty: early experience, Clin Orthop Relat Res, 416, pp. 185-190, (2003)
  • [4] Samama C.M., A direct antifibrinolytic agent in major orthopedic surgery, Orthopedics, 27, pp. 675-680, (2004)
  • [5] Rama K.R., Apsingi S., Poovali S., Jetti A., Timing of tourniquet release in knee arthroplasty. Meta-analysis of randomized, controlled trials, J Bone Joint Surg Am, 89, 4, pp. 699-705, (2007)
  • [6] Kalairajah Y., Simpson D., Cossey A.J., Verrall G.M., Spriggins A.J., Blood loss after total knee replacement: effects of computer-assisted surgery, J Bone Joint Surg Br, 87-B, 11, pp. 1480-1482, (2005)
  • [7] Benoni G., Fredin H., Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty: a prospective, randomised, double-blind study of 86 patients, J Bone Joint Surg Br, 78, pp. 434-440, (1996)
  • [8] Seol Y.J., Seon J.K., Lee S.H., Jin C., Prakash J., Park Y.J., Song E.K., Effect of tranexamic acid on blood loss and blood transfusion reduction after total knee arthroplasty, Knee Surg Relat Res, 28, 3, pp. 188-193, (2016)
  • [9] Hynes M., Calder P., Scott G., The use of tranexamic acid to reduce blood loss during total knee arthroplasty, Knee, 10, pp. 375-377, (2003)
  • [10] Akgul T., Buget M., Salduz A., Edipoglu I.S., Ekinci M., Kkay S., Sen C., Efficacy of preoperative administration of single high dose intravenous tranexamic acid in reducing blood loss in total knee arthroplasty: a prospective clinical study, Acta Orthop Traumatol Turc, 50, 4, pp. 429-431, (2016)
12