scholarly journals The combined effect of administration of intravenous and topical tranexamic acid on blood loss and transfusion rate in total knee arthroplasty

2016 ◽  
Vol 5 (8) ◽  
pp. 353-361 ◽  
Author(s):  
Z. F. Yuan ◽  
H. Yin ◽  
W. P. Ma ◽  
D. L. Xing
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Combined Effect ◽  
Transfusion Rate ◽  
Total Knee ◽  
Topical Tranexamic Acid

scholarly journals Effect of Topical Tranexamic Acid on Reducing Blood Loss in Primary Total Knee Arthroplasty in Southern Chinese Population

2018 ◽  
Vol 25 (1) ◽  
pp. 73-75 ◽  
Author(s):  
Kwok Pui Pui ◽  
Ho Ka Ki ◽  
Yang Isaac Bruce ◽  
Sha Wai Leung ◽  
Wong Hok Leung ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Postoperative Blood Loss ◽  
Transfusion Rate ◽  
Total Knee ◽  
Topical Tranexamic Acid ◽  
Primary Total Knee

The objective of this study was to evaluate the efficacy of topical tranexamic acid (TA) on the postoperative blood loss and transfusion rate after primary total knee arthroplasty (TKA). Two hundred ninety-six patients (n = 296) undergoing TKA in Pok Oi Hospital were included in this study from July 2015 to September 2016. The topical TA group (n =154) showed a significant reduction in haemoglobin drop (2.76 g/dL vs. 3.62 g/dL, p < 0.001), haematocrit drop (0.0876 vs. 0.112, p < 0.001), transfusion rate (3.2% vs. 23.9%, p < 0.001), drain output (199 mL vs. 276 mL, p < 0.001) and length of stay (9 days vs. 11 days, p < 0.001) compared with those in the control group (n = 142). There was no thromboembolic complication associated with TA use. The results supported the use of topical TA to control postoperative blood loss after TKA.

One step closer to sparing total blood loss and transfusion rate in total knee arthroplasty: a meta-analysis of different methods of tranexamic acid administration

2015 ◽  
Vol 135 (4) ◽  
pp. 573-588 ◽  
Author(s):  
Hamidreza Shemshaki ◽  
Sayed Mohammad Amin Nourian ◽  
Niloofaralsadat Nourian ◽  
Masoudhatef Dehghani ◽  
Masoud Mokhtari ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Meta Analysis ◽  
Transfusion Rate ◽  
Total Blood ◽  
One Step ◽  
Total Knee ◽  
Acid Administration

One Versus Two Doses of Intravenous Tranexamic Acid in Total Knee Arthroplasty

2019 ◽  
Author(s):  
Ryan S. Charette ◽  
Jenna A. Bernstein ◽  
Matthew Sloan ◽  
Corbyn M. Nchako ◽  
Atul F. Kamath ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Total Knee Arthroplasty ◽  
Deep Vein Thrombosis ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Transfusion Rate ◽  
Vein Thrombosis ◽  
Total Knee ◽  
Deep Vein

AbstractTranexamic acid (TXA) has been shown to reduce blood loss and postoperative transfusions in total knee arthroplasty (TKA). There is no consensus on the ideal dosing regimen in the literature, although there is a growing body of literature stating there is little benefit to additional doses. Our study compared one versus two doses of TXA in primary TKA and its effect on postoperative transfusion rate. We retrospectively reviewed patients undergoing primary TKA at our two high-volume arthroplasty centers between 2013 and 2016. Patients were included if they underwent unilateral primary TKA, and received one or two doses of intravenous TXA. Patients receiving therapeutic anticoagulation were excluded. Our primary outcome was postoperative transfusion rate. Secondary outcomes included blood loss, length of stay, rate of deep vein thrombosis or pulmonary embolism (DVT/PE), readmission and reoperation.A total of 1,191 patients were included: 891 received one dose and 300 received two doses. There was no significant difference in rate of transfusion, deep vein thrombosis or pulmonary embolism (DVT/PE), blood volume loss, and reoperation. There was a significantly higher risk of readmission (6.7 vs. 2.4%, odds ratio [OR] 2.96, p < 0.001) and reoperation (2.0 vs. 0.6%, OR 3.61, p = 0.024) in patients receiving two doses. These findings were similar with subgroup analysis of patients receiving only aspirin prophylaxis.In unilateral TKA, there is no difference in transfusion rate with one or two doses of perioperative TXA. There was no increased risk of thromboembolic events between groups, although the two-dose group had a higher rate of readmission and reoperation. Given the added cost without clear benefit, these findings may support administration of one rather than two doses of TXA during primary TKA.

scholarly journals Significantly reducing blood loss via a peri-articular injection of tranexamic acid during total knee arthroplasty: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yu-Kuan Lin ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Chao-Ming Chen ◽  
Jesse Chieh-Szu Yang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Retrospective Study ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Transfusion Rate ◽  
Group I ◽  
Significant Difference ◽  
Total Knee ◽  
Group Ii

Abstract Background The administration of an intra-articular injection (IAI) of tranexamic acid (TXA) has been demonstrated to be effective in reducing both blood loss and transfusion rate during total knee arthroplasty (TKA); however, few studies have reported the efficiency of a peri-articular injection (PAI) of TXA. We studied the efficiency of a PAI of TXA in reducing blood loss during TKA. Methods Fifty patients undergoing primary simultaneous bilateral TKA were enrolled in this retrospective study. The right knee received a PAI of 1 g of TXA (Group I), and the left knee received an IAI of 1 g of TXA (Group II). The clinical outcome measures were a change in blood loss from Hemovac drains and surgical time. Results The decrease in blood loss from the Hemovac was significantly lower in Group I (460.1 ± 36.79 vs. 576.0 ± 34.01, P < 0.001) than in Group II, and no significant difference in surgical times was observed. The blood transfusion rate in the present study was 16 %. Conclusions A PAI of TXA may reduce blood loss more efficiently than an IAI of TXA during TKA without increased complications such as surgical site infection, poor wound healing, skin necrosis, pulmonary embolism, and deep vein thrombosis.

scholarly journals Significantly Reducing Blood Loss Using Intra-muscular Injection of Tranexamic Acid during Total Knee Arthroplasty

2020 ◽  
Author(s):  
Yu-Kuan Lin ◽  
Shang-Wen Tsai ◽  
Po-Kuei Wu ◽  
Chao-Ming Chen ◽  
Jesse Chieh-Szu Yang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Transfusion Rate ◽  
Reduce Blood Loss ◽  
Group I ◽  
Significant Difference ◽  
Total Knee ◽  
Group Ii

Abstract Background Administration of an intra-muscular injection (IMI) of tranexamic acid (TXA) had been demonstrated to be effective in reducing both blood loss and the transfusion rate during total knee arthroplasty (TKA). However, few studies have reported on the efficiency of IMI of TXA. We studied the efficiency of IMI of TXA to reduce blood loss during TKA. Methods In this prospective study, 50 patients undergoing primary simultaneous bilateral TKA were enrolled. The right knee received a IMI of 1 g of TXA (Group I), and the left knee received an intra-articular injection (IAI) of 1 g of TXA (Group II). The clinical outcome measures were a change in hemoglobin levels, blood loss from Hemovac, and number of allogeneic blood units. Results Compared with Group II, the decrease in blood loss from Hemovac was significantly less for Group I (460.1 ± 36.79 vs. 576.0 ± 34.01, P < 0.001), and no significant difference in surgical times was observed. Conclusions IMI of TXA can significantly reduce blood loss than IAI of TXA during TKA without increased complications such as surgical site infection, poor wound healing, skin necrosis, pulmonary embolism, and deep vein thrombosis.

scholarly journals Blood Loss Control with Two Doses of Tranexamic Acid in a Multimodal Protocol for Total Knee Arthroplasty

2011 ◽  
Vol 5 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Miguel Ortega-Andreu ◽  
Hanna Pérez-Chrzanowska ◽  
Reyes Figueredo ◽  
Enrique Gómez-Barrena
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Disease Transmission ◽  
Length Of Hospital Stay ◽  
Transfusion Rate ◽  
Postoperative Blood Transfusion ◽  
Transfusion Requirements ◽  
Total Knee

Average blood loss after total knee arthroplasty (TKA) usually ranges from 1500 to 1900 cc, including both the postoperative drain and hidden blood loss. This represents about 46% of TKA patients requiring postoperative blood transfusion. Not only the risks of disease transmission but also those of ABO incompatibility, infection due to immunosupression, increased procedure costs, and increased length of hospital stay, are potential problems that foster blood saving strategies. In this study, 71 unilateral TKAs using a multimodal protocol to decrease blood loss were compared to 61 historical cases. Patients in both groups underwent cemented TKA with the same system, surgical technique, and multimodal protocol (MIS approach, plug in the femoral canal, tourniquet removal after wound closure and compressive bandage, analgesic periarticular infiltration with vasoconstrictor, postoperative drain at atmospheric pressure, opened 2 hours after the end of the surgical procedure and removed after 24 hours). The study series incorporated intravenous tranexamic acid (TXA) infusion in 2 doses of 10-15 mg/kg, 15 minutes before tourniquet release and 3 hours later. Results showed no transfusion requirements in the TXA series (0%), with 23/61 (37.7%) transfusions in the control, with an average cost decrease of 240 euros per patient. Visible bleeding in 24h significantly decreased from 553.36 cc (range 50-1500) to 169.72 cc (range 10-480) in the TXA series. As a conclusion, implementing a TXA-based multimodal protocol produced significant decrease in the transfusion rate, visible blood loss, and cost per patient, thus proving effectiveness and efficiency in the surgical management of TKA.

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