Purpose This is a randomised controlled trial to examine whether intra-articular injection of tranexamic acid (TXA) decreases blood loss, as well as reducing leg swelling after total knee arthroplasty (TKA). Methods We performed 100 TKA in osteoarthritis patients. At closure, a total of 2,000 mg/20 ml TXA was injected into the knee joint through a closed suction drain (TXA group). For the control group, the same volume of physiological saline was injected. The pre-operative condition of the patients, post-operative haemoglobin (Hb) levels, discharge volumes from drain, D-dimer and needs for transfusion were compared between these two groups. Furthermore, leg diameters (thigh, suprapatellar portion and calf girth) were measured pre-and post-operatively to investigate whether TXA has an influence on leg swelling after surgery. Results The results revealed that post-operative decrease in Hb level was significantly reduced in the TXA group. Furthermore, knee joint swelling after operation was significantly suppressed in the TXA group compared to the control group. Conclusions The results revealed intra-articular administration of TXA decreased not only blood loss, but also knee joint swelling after TKA.
This retrospective, observational study was designed to investigate factors affecting successful prosthetic ambulation in elderly amputees aged > or = 60 years. The study included 64 unilateral transfemoral or hip disarticulation amputees. Patients who were able to walk > or = 100 m with prosthesis were classified as successful and those who could walk < 100 m as failures. Age, comorbidities, cause of amputation, ability to stand on one leg, patient's motivation for walking and maximum oxygen uptake as a proportion of predicted maximum oxygen uptake (%VO(2max)) during an exercise load test were examined as indicators of physical fitness. Significant differences were noted between the two groups in the number of comorbidities, ability to stand on one leg, patient's motivation for walking and mean %VO(2max). A low number of comorbidities, the ability to stand on one leg, motivation for walking and adequate physical fitness allowing an exercise intensity of > or = 50% VO(2max) were considered to be predictive factors for successful prosthetic rehabilitation.
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