The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial

Hishimura, Ryosuke; Onodera, Tomohiro; Ohkoshi, Yasumitsu; Okada, Kazufumi; Matsuoka, Masatake; Matsubara, Shinji; Iwasaki, Koji; Kondo, Eiji; Iwasaki, Norimasa

The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial

Hishimura, Ryosuke; Onodera, Tomohiro; Ohkoshi, Yasumitsu et al.

BMC musculoskeletal disorders, 2022, 23(1), 111

Permalink : https://hdl.handle.net/2115/84464

このアイテムのアクセス数:378件（2026-03-20 17:32 集計）

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アクセス権	metadata only access
URI	https://hdl.handle.net/2115/84464
タイトル	The effect of local injection of tranexamic acid into peri-articular tissue versus drain clamping in total knee arthroplasty: a randomized controlled trial
著者	Hishimura, Ryosuke ; Onodera, Tomohiro ; Ohkoshi, Yasumitsu ; Okada, Kazufumi ; Matsuoka, Masatake ; Matsubara, Shinji ; Iwasaki, Koji ; Kondo, Eiji ; Iwasaki, Norimasa
著者名 Hishimura, Ryosuke
e-Rad_Researcher 70547174 著者名 Onodera, Tomohiro
著者名 Ohkoshi, Yasumitsu
著者名 Okada, Kazufumi
e-Rad_Researcher 70816066 著者名 Matsuoka, Masatake
著者名 Matsubara, Shinji
e-Rad_Researcher 40771895 著者名 Iwasaki, Koji
e-Rad_Researcher 60374724 著者名 Kondo, Eiji
e-Rad_Researcher 30322803 著者名 Iwasaki, Norimasa
言語	英語
キーワード	Tranexamic acid (TXA)
	Periarticular local injection
	Total knee arthroplasty (TKA)
	Drain clamping
発行日	2022-02-02
出版者	BioMed Central
収録物名	BMC musculoskeletal disorders
巻(号)	23(1)
ページ	111
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1186/s12891-022-05058-6