Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
The Efficacy of Intravenous Versus Topical Use of Tranexamic Acid in Reducing Blood Loss After Primary Total Knee Arthroplasty: A Randomized Clinical Trial Publisher



Torkaman A1 ; Rostami A2, 7 ; Sarshar MR3 ; Aghdam HA4, 5 ; Motaghi P6 ; Yazdi H2, 7
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Knee Surgery, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
  2. 2. Bone and Joint Reconstruction Research Center, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Bone and Joint Reconstruction Research Center, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Iran University of Medicals Sciences, Tehran, Iran
  7. 7. Bone and Joint Reconstruction Research Center, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran

Source: Archives of Bone and Joint Surgery Published:2020


Abstract

Background: Blood loss during and immediately after total knee arthroplasty (TKA) is among the most challenging concerns. It has been demonstrated that Tranexamic acid (TXA) can help to reduce perioperative blood loss. TXA can be used as an oral, topical or intravenous injection. Many studies evaluated the effectiveness of each route of administration but few works on a comparison between them. The current study aimed to compare the effectiveness of intravenous injection versus topical use of TXA in reducing perioperative blood loss after primary total knee arthroplasty. Methods: Eighty-five patients who were a candidate for total knee arthroplasty were randomized into two groups: one group received Intravenous injection of 15 mg/kg TXA, 10 min before tourniquet inflation while the other group received 1 g diluted TXA during wound closure. The postoperative blood loss was estimated by measuring the whole drain output and also hemoglobin (HB) drops. Both groups compared based on the need for allogenic blood transfusion and also thromboembolic events. Results: Patients who received topical TXA had a higher total drain output (P<0.0001) compared to intravenous injection. The hemoglobin drop also was more in the topical group although it was marginally significant (P=0.05). Conclusion: Intravenous injection of TXA is more effective in reducing postoperative blood loss after primary TKA compared to topical administration. © BY THE ARCHIVES OF BONE AND JOINT SURGERY.
Related Docs
View other Related Docs
1. The Effect of Topical Tranexamic Acid Versus Injection Into the Clamped Drain on Postsurgical Bleeding in Knee Arthroplasty Surgery: A Double-Blind Randomized Clinical Trial Study, Journal of Isfahan Medical School (2018)
2. 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, Archives of Orthopaedic and Trauma Surgery (2015)
3. Re-Evaluating the Effect of Preoperative Tranexamic Acid on Blood Loss and Field Quality During Rhinoplasty: A Randomized Double-Blinded Controlled Trial, Aesthetic plastic surgery (2022)
4. The Effect of Tranexamic Acid Injection During Anterior Cruciate Ligament Reconstruction Surgery on Postoperative Bleeding, Pain and Swelling, European Journal of Orthopaedic Surgery and Traumatology (2023)
5. Evaluation of Topical Tranexamic Acid on Intraoperative Bleeding in Endoscopic Sinus Surgery, Iranian Journal of Medical Sciences (2006)
6. The Effect of Intravenous Tranexamic Acid Before and During Spinal Surgery in Bleeding Volume During and After Surgical Operation, Iranian Journal of Neurosurgery (2019)
7. Re-Evaluation of the Efficacy of Tranexamic Acid in Reducing Blood Loss in Percutaneous Nephrolithotomy: A Randomized Clinical Trial, Minerva Urologica e Nefrologica (2019)
8. Evaluating the Effectiveness of Tranexamic Acid Administration in Reducing Bleeding in Benign Prostate Hyperplasia Patients Underwent Open Prostatectomy: A Double-Blind Randomized Clinical Trial, Journal of Research in Medical Sciences (2023)
Experts (# of related papers)
View all Related Experts
Mehdi Motififard (8)
Amin Nemati (3)
Other Related Docs
9. Prophylactic Effect of Tranexamic Acid on Hemorrhage During and After the Cesarean Section, International Journal of Women's Health and Reproduction Sciences (2019)
10. Does Topical Tranexamic Acid Reduce Postcoronary Artery Bypass Graft Bleeding?, Journal of Research in Medical Sciences (2018)
11. No Difference Between Wound Closure in Extension or Flexion for Range of Motion Following Total Knee Arthroplasty: A Randomized Clinical Trial, Knee Surgery, Sports Traumatology, Arthroscopy (2016)
12. Comparing Vancomycin-Tranexamic Acid Paste to Vancomycin-Normal Saline Paste in Reducing Post Coronary Artery Bypass Graft Surgery Bleeding, International Cardiovascular Research Journal (2020)
13. Effect of Additioning of Triamcinolon to Cocktail of Fentanil Epinephrinated Bupivacaine in Periarticular Injection for Post Operative Pain and Quality Improvement After Total Knee Arthroplasty, Journal of Isfahan Medical School (2011)
14. Pre-Emptive Injection of Peri-Articular-Multimodal Drug for Post-Operative Pain Management in Total Knee Arthroplasty: A Double-Blind Randomized Clinical Trial, International Orthopaedics (2017)
15. Predictive Factors for Length of Stay in Patients Undergoing Total Hip Arthroplasty: A Cross-Sectional Study, Medical Journal of the Islamic Republic of Iran (2023)
16. The Effect of Tranexamic Acid on Traumatic Brain Hematomas, Journal of Isfahan Medical School (2016)
17. The Effect of Intravenous Tranexamic Acid on Preventing the Progress of Cerebral Hemorrhage in Patients With Brain Traumatic Injuries Compared to Placebo: A Randomized Clinical Trial, Medical Journal of the Islamic Republic of Iran (2020)
18. Comparison of the Effects of Preoperative Celecoxib and Gabapentin on Pain, Functional Recovery, and Quality of Life After Total Knee Arthroplasty: A Randomized Controlled Clinical Trial, Journal of Research in Medical Sciences (2023)
19. Comparison of Intravenous and Epidural Patient-Controlled Analgesia After Knee and Hip Arthroplasty, Journal of Isfahan Medical School (2012)
20. Effects of Tranexamic Acid on Bleeding and Hemoglobin Levels in Patients With Staghorn Calculi Undergoing Percutaneous Nephrolithotomy: Randomized Controlled Trial, Iranian Journal of Medical Sciences (2019)
21. Comparing the Effectiveness Results of Heparin and Enoxaparin After Total Hip Artroplasty, Journal of Isfahan Medical School (2013)
22. Knee Fusion Versus Above Knee Amputation As Two Options to Deal With Knee Periprosthetic Joint Infection, Archives of Orthopaedic and Trauma Surgery (2024)
23. Use of Tranexamic Acid in Bleeding Control of Transabdominal and Transvaginal Hysterectomy, Advanced Biomedical Research (2022)
24. Comparing Preemptive Injection of Peri-Articular-Multimodal Drug With Oral Celexocib for Postoperative Pain Management in Total Knee Arthroplasty: A Randomized Clinical Trial, Journal of Research in Medical Sciences (2023)
25. The Effect of Intravenous Tranexamic Acid on Perioperative Bleeding and Surgeon’S Satisfaction During Mastoidectomy, Journal of Isfahan Medical School (2017)
26. Reduced Morphine Consumption and Pain Severity With Transdermal Fentanyl Patches Following Total Knee Arthroplasty, Knee Surgery, Sports Traumatology, Arthroscopy (2014)
27. Length of Stay in Patients Undergoing Total Knee Arthroplasty, Journal of Orthopaedics (2022)
28. Evaluation of Tranexemic Acid Effect on Blood Loss and Transfusion in Femoral Shaft Surgery, Journal of Isfahan Medical School (2012)
29. Comparison of the Effects of Tranexamic Acid and Remifentanil on the Reduction of Intraoperative and Postoperative Hemorrhage During Dacriocystorhynostomy, Scientific Journal of Kurdistan University of Medical Sciences (2022)
30. Comparison of Performance and Pain Intensity After Total Knee Arthroplasty Using General or Regional Anesthesia, Journal of Isfahan Medical School (2012)
31. Dabigatran Versus Enoxaparin in the Prevention of Venous Thromboembolism After Total Knee Arthroplasty: A Randomized Clinical Trial, ARYA Atherosclerosis (2014)
32. Selection of the Optimal Dosage of Tranexamic Acid to Reduce Blood Loss During Pediatric Cleft Palate Surgery, Tzu Chi Medical Journal (2021)
33. Comparison of Postoperative Pain and Clinical Outcomes of Total Knee Arthroplasty Among Patients With Rheumatoid Arthritis and Osteoarthritis Referred to Clinic or Emergency Department, Advanced Biomedical Research (2023)