Postoperative Drainage in Total Knee Arthroplasty in the Presence of Tranexamic Acid

2019 ◽  
Author(s):  
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Postoperative Drainage ◽  
Total Knee

scholarly journals Effect of tranexamic acid on the timing of drainage tube removal in total knee arthroplasty

2020 ◽  
Vol 8 (9_suppl7) ◽  
pp. 2325967120S0052
Author(s):  
Wang Jinliang ◽  
Wei Xuan
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Acid Group ◽  
Drainage Tube ◽  
Total Blood ◽  
Drainage Volume ◽  
Postoperative Drainage ◽  
Total Knee

Introduction: To investigate the effect of tranexamic acid on the removal time of drainage tube in the first unilateral total knee arthroplasty. Hypotheses: The timing of removing the drinage system can be changed when using TXA. Methods: From June 2017 to December 2018, 182 patients (42 males and 140 females) who planned to undergo primary unilateral total knee replacement were included.Age (68.1±7.1) years (60-76 years).According to the random number table method, it was divided into four groups: 45 cases of Tranexamic acid group 1 (TXA1), 46 cases of Tranexamic acid group 2 (TXA2), 46 cases of Tranexamic acid group 3 (TXA3) and None Tranexamic acid group (NTXA).TXA1-3 group intraoperative intravenous infusion combined with local application of tranexamic acid;NTXA group was locally perfused in the joint cavity with 100ml normal saline only after surgery.Differences in drainage volume, total blood loss, invisible blood loss, degree of postoperative joint swelling, Hospital for special surgery (HSS) and visual analogue scale (VAS) of pain were compared among the four groups. Results: The postoperative drainage volume of TXA1˜3 groups was 85.5±34.3ml, 189.4±72.3ml and 215.3±93.4ml, respectively, which was less than that of the non-tranexamic acid group (351.3±113.5ml). The overall difference was statistically significant (F=11.5,P=0.005). The postoperative drainage volume of tranexamic acid 1 group was less than that of tranexamic acid 2 and 3 groups.The total postoperative blood loss was 699.0±255.7ml, 710.4±296.1ml, and 715.8±248.2ml in the tranexamic acid 1-3 groups, respectively, which was less than 1130.5±354.2ml in the non-tranexamic acid group, and the overall difference was statistically significant (F=13.1,P=0.001).On the 4th day after the operation, the knee swelling degree of the tranexamic acid 1- 3 groups was 1.25±0.07, 1.13±0.12, and 1.12±0.13, respectively, which were smaller than that of the non-tranexamic acid group (1.43±0.22), and the overall difference was statistically significant (F=8.23, P=0.015).There were 2 cases of positive bacterial culture in non-tranexamic acid group and tranexamic acid group.There were 3 cases of hematoma in the non-tranexamic acid group,and 1 case of delayed wound healing. Conclusion: The application of tranexamic acid after TKA can reduce postoperative drainage volume, latent blood loss and total blood loss.The removal of the drainage tube 18h after the operation can not only fully drain,relieve pain, promote the recovery of knee joint function, but also effectively reduce the risk of infection caused by the drainage tube.

scholarly journals Intra-Articular Injection of Tranexamic Acid to Reduce Blood Loss after Total Knee Arthroplasty

2014 ◽  
Vol 22 (2) ◽  
pp. 146-149 ◽  
Author(s):  
Bob Jang ◽  
Mark Kao ◽  
Martin T Bohm ◽  
Ian A Harris ◽  
Darren B Chen ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Reduce Blood Loss ◽  
Total Knee

scholarly journals Topical vs. intravenous administration of tranexamic acid in knee arthroplasty and prevalence of deep venous thrombosis: a randomized clinical trial

2016 ◽  
Vol 15 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Ari Zekcer ◽  
Ricardo Del Priori ◽  
Clauber Tieppo ◽  
Ricardo Soares da Silva ◽  
Nilson Roberto Severino
Keyword(s):  
Total Knee Arthroplasty ◽  
Tranexamic Acid ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Intravenous Administration ◽  
Knee Arthroplasty ◽  
Duplex Ultrasound ◽  
Control Group ◽  
Perioperative Bleeding ◽  
Total Knee

Abstract Background Tranexamic acid (TXA) is widely used in orthopedic surgery to reduce perioperative bleeding. Since TXA inhibits fibrinolysis, there is concern that it may increase the risk of thromboembolic events. Objectives To verify the prevalence of deep venous thrombosis (DVT) in patients receiving TXA during total knee arthroplasty and to compare topical with intravenous administration of the drug. Methods All patients admitted for total knee arthroplasty due to primary arthrosis between June and November of 2014 were recruited consecutively. Thirty patients were randomized to a “topical group” (1.5 g TXA diluted in 50ml saline sprayed over the area operated, before tourniquet release), 30 to an “intravenous group” (20mg/kg TXA in 100 ml of saline, given at the same time as anesthesia), and 30 to a control group (100 ml of saline, given at the same time as anesthesia). All patients had duplex ultrasound scans of the legs on the 15th postoperative day. Results Deep venous thrombosis events occurred in five of the 90 patients operated (one out of 30 in the topical group [3.3%], four out of 30 in the control group [13.3%], and zero in the intravenous group). All were confirmed by duplex ultrasound scans and all were asymptomatic. Prevalence rates of DVT were similar between groups (p = 0.112 for control vs. intravenous; p = 0.353 for control vs. topical; and p =1.000 for intravenous vs. topical, according to two-sided exact tests). Conclusions Both topical and intravenous administration of TXA are safe with regard to occurrence of DVT, since the number of DVT cases in patients given TXA was not different to the number in those given placebo.

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