ABSTRACT
Background: Total hip replacement surgery is one of the most advanced and technically demanding surgeries in orthopaedics in which blood loss is inevitable. Most of the patients are elderly with multiple co morbidities and the estimated one-year mortality is about 25%. Objective of the study was to assess the need of post-operative blood transfusion in total hip replacement surgery in patients given tranexamic acid versus control. Methods: It was a randomized controlled trial. Sixty patients of both sexes undergoing total hip replacement surgery included in study on the basis of inclusion and exclusion. Equal patients 30-30 (50%) divided in two groups Tranexamic Acid group and Control Group based on a computer-generated random number table. The Tranexamic Acid group received two doses of 10mg/kg body weight of tranexamic acid just before surgery and two hours later intravenously, whereas Control group received two doses of 10mg/kg body weight of normal saline at similar intervals. Numbers of blood transfusions required postoperatively were noted based on the postoperative haemoglobin readings. Results: Mean post-op haemoglobin for the Tranexamic acid group was 10.1±2.6 g/dl and for the Control group it was 9.1±2.4 g/dl. Seven patients (23%) in intervention group required blood transfusion compared to 13 (43%) in control group. Conclusions: Our study revealed that Perioperative Tranexamic acid is a safe and useful method of reducing intra op bleeding and need of post-operative blood transfusion postoperatively in THR patients.
ABSTRACT
Background: Osteoarthritis (OA) is the most common disease of joints in adults around the world. The aim of the study was to assess functional outcome and results of injection of hyaluronic acid in symptomatic osteoarthritis knee. Methods: It was a prospective clinical study with 3 months of follow-up was conducted in the Dept. of Orthopaedics, Pacific Medical College and Hospital, Udaipur. Clinically proven n=35 patients of osteoarthritis knee (OA) included in study on the basis of inclusion and exclusion. Enrolled patients were treated by weekly intra articular injection of Hyaluronic acid (20 mcg/2ml) in affected knee joint for 5 weeks. Functional outcome and clinical assessment was done by pain at visual analogue score (VAS) and by knee range of movements, patients global assessment of treatment and physician global assessment of treatment. Results: Thirty Five patients participated in study and reported statistically significant improvement in VAS score in mild and moderate osteoarthritis of knee from 4.46±0.52 and 7.17±0.96 points respectively pre-treatment level to 3.36±0.63 and 5.26±0.44 points respectively at three months post Hyaluronic acid injection follow up, improvement in joint tenderness and patients & physician’s global assessment score also improved significantly clinically as well as statistically in mild to moderate group while in severe group no clinical and statistically significant improvement was observed in any parameter. Conclusions: We concluded that intra articular injection hyaluronic acid should be considered as safe and effective modality of treatment in selected group of mild to moderate osteoarthritis only.