Local application of different doses of tranexamic acid without drainage reduces blood loss after total knee arthroplasty / 中国组织工程研究

ABSTRACT

BACKGROUND: Total knee arthroplasty (TKA) is an effective method for the end-stage knee osteoarthritis, which can obviously relieve pain and improve function. But a large amount of postoperative blood loss is a serious complication, how to reduce postoperative blood loss is still a difficulty. OBJECTIVE: To explore the efficacy of local application of different doses of tranexamic acid without drainage on the METHODS: 150 patients with osteoarthritis who underwent TKA were randomly divided into three groups (n=50 per group). Group A received the intra-articular injection of tranexamic acid (2 g) plus 50 mL of normal saline; group B received the intra-articular injection of tranexamic acid (1 g) 50 mL of normal saline; group C received the intra-articular injection of 50 mL of normal saline. The drainage tube was not used in all patients. The number of hemoglobin, the number of patients undergoing blood transfusion, intraoperative blood loss, external blood loss, hidden blood loss, total blood loss and postoperative 3 hour-related blood coagulation indexes were recorded and compared among groups. Additionally, the incision infection and deep vein thrombosis were observed. RESULTS AND CONCLUSION: (1) The difference of hemoglobin among groups was significant (F=7.218-7.516, P=0.000).(2)The number of blood transfusion in the groups A,B and C was 2,5 and 9,respectively,which had significant differences (χ2=25.753, P=0.000). (3) The intraoperative blood loss had no significant difference among groups (F=1.206, P=5.283). The difference in the postoperative external blood loss, postoperative hidden blood loss and total postoperative blood loss among groups was significant (F=14.389, P=0.000; F=7.158, P=0.009; F=6.752, P=0.012). Moreover, the hemostatic effect was in a dose-dependent manner. (4) There were no significant differences in the postoperative 3-hour-related blood coagulation indexes among groups (P > 0.05). (5) There was no deep vein thrombosis at 1 week postoperatively, and no deep vein thrombosis or pulmonary embolism occurred within postoperative 3 months in the three groups. (6) To conclude, topical application of tranexamic acid without drainage can significantly reduce perioperative blood loss, blood transfusion rate, and does not increase the incidence of complications, and the hemostatic effect is in a dose-dependent manner.