|
Hokkaido University Collection of Scholarly and Academic Papers >
Hokkaido University Hospital >
Peer-reviewed Journal Articles, etc >
The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial
| Title: | The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial |
| Authors: | Hishimura, Ryosuke Browse this author | | Onodera, Tomohiro Browse this author →KAKEN DB | | Ohkoshi, Yasumitsu Browse this author | | Okada, Kazufumi Browse this author | | Matsuoka, Masatake Browse this author →KAKEN DB | | Matsubara, Shinji Browse this author | | Iwasaki, Koji Browse this author →KAKEN DB | | Kondo, Eiji Browse this author →KAKEN DB | | Iwasaki, Norimasa Browse this author →KAKEN DB |
| Keywords: | Tranexamic acid (TXA) | | Periarticular local injection | | Total knee arthroplasty (TKA) | | Drain clamping |
| Issue Date: | 2-Feb-2022 |
| Publisher: | BioMed Central |
| Journal Title: | BMC musculoskeletal disorders |
| Volume: | 23 |
| Issue: | 1 |
| Start Page: | 111 |
| Publisher DOI: | 10.1186/s12891-022-05058-6 |
| Abstract: | Background Tranexamic acid (TXA) is used as a synthetic anti-fibrinolytic agent for total knee arthroplasty (TKA) to reduce postoperative bleeding. Though the effects on bleeding reduction of several methods of administering TXA have been demonstrated, the optimal method remains controversial. Recently, the hemostatic effect of periarticular local injection of TXA during TKA was reported. Although this method can be expected to suppress postoperative bleeding without placing a drain, its hemostatic effect has not yet been assessed in comparison with local injection and other methods of administering TXA. The aim of this randomized, prospective study was to assess the efficacy of local injection of TXA during TKA. Methods To confirm the effect of the local injection of TXA, drain clamping was set as the control. The subjects included a prospective series of 109 patients randomly divided into 2 groups: the local injection (group L) and the drain clamping (group D). The main outcome measure was postoperative bleeding. Secondary outcomes included pain, physical measurements, and laboratory findings. Results The calculated total blood loss (CTBL) in groups L and D was nearly equal and did not show the non-inferiority of group L to group D (883 +/- 248 vs. 841 +/- 257 ml, P = .564). Drained blood loss was significantly higher in group L than in group D (395 +/- 130 vs 276 +/- 78.8 ml, P < .0001). There was no significant difference in hidden blood loss between the groups (488 +/- 269 vs 565 +/- 261 ml, P = .131). The other laboratory findings and physical measurements were identical between the groups. Conclusions Although CTBL in group L did not show non-inferiority to group D, the local injection of TXA was considered to be superior for suppressing bleeding considering the risk of the adverse effects of using a drain. |
| Type: | article |
| URI: | http://hdl.handle.net/2115/84464 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
|
|
