Platelet-Rich Plasma (Prp) and Tranexamic Acid (Txa) Applied in Total Knee Arthroplasty

Guerreiro, João Paulo Fernandes; Lima, Diogenes Rodrigues; Bordignon, Glaucia; Danieli, Marcus Vinicius; Queiroz, Alexandre Oliveira; Catâneo, Daniele Cristina

doi:10.1590/1413-785220192705214417

Cited by 4 publications

(17 citation statements)

References 16 publications

(10 reference statements)

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“…Six RCT studies including 621 patients evaluated the use of PRP as an adjunct to TKA ( Table 4 ). All studies applied PRP intraoperatively: three sprayed platelet gel onto the exposed surface of the wound [ 16 , 17 , 18 ] and the other three injected PRP into the joint [ 19 , 20 , 21 ]. The aim of all these studies was to assess potential blood loss during the procedure after TKA.…”

Section: Resultsmentioning

confidence: 99%

“…Lower hemoglobin drop was reported in all six studies [ 16 , 17 , 18 , 19 , 20 , 21 ] with significant differences and two studies reported lower calculated blood loss in the PRP group ( p > 0.05; p < 0.001) [ 17 , 21 ]. There were significant differences in favor of PRP in comparison to the control groups for the overall effect on blood parameters (standardized mean difference −0.29, 95% CI (−0.46, −0.11), p = 0.001) for the pooled estimates for all six studies ( Figure 4 A).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies reported better pain control in the PRP group (VAS) for a short time period after surgery [ 16 , 18 , 19 , 20 ]. No effect was observed in long-term follow-up.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies [24,25,27,28] reporting outcomes measured in IKDC ( Figure 5B), showed significant differences in favor of PRP (p < 0.00001). In subgroup analysis, two RCTs Four studies reported better pain control in the PRP group (VAS) for a short time period after surgery [16,[18][19][20]. No effect was observed in long-term follow-up.…”

Section: Arthroscopymentioning

confidence: 98%

“…This study showed significant differences in KOOS and VAS in favor of PRP with the addition of Mesenchymal Stem Cells (MSC) in a 2-year follow up (p < 0.05). Second-look arthroscopy Four studies reported better pain control in the PRP group (VAS) for a short time period after surgery [16,[18][19][20]. No effect was observed in long-term follow-up.…”

Section: High Tibial Osteotomy (Hto)mentioning

confidence: 99%

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The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery—A Systematic Review and Meta-Analysis

Tramś

Kulinski

Kozar-Kamińska

et al. 2020

Life

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In recent years, the interest in biological treatment of knee lesions has increased, especially the application of platelet-rich plasma is of particular note. The number of articles evaluating platelet-rich plasma (PRP) efficacy in the recovery of knee disorders and during knee surgery has exponentially increased over the last decade. A systematic review with meta-analyses was performed by assessing selected studies of local PRP injections to the knee joint. The study was completed in accordance with 2009 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A multistep search of PubMed, Embase, Cochrane Database of Systematic Reviews, and Clinicaltrials.gov was performed to identify studies on knee surgery and knee lesion treatment with PRP. Of the 4004 articles initially identified, 357 articles focusing on knee lesions were selected and, consequently, only 83 clinical trials were analyzed using the revised Cochrane risk-of-bias tool to evaluate risk. In total, seven areas of meta-analysis reported a positive effect of PRP. Among them, 10 sub-analyses demonstrated significant differences in favor of PRP when compared to the control groups (p < 0.05). This study showed the positive effects of PRP, both on the recovery of knee disorders and during knee surgery; however further prospective and randomized studies with a higher number of subjects and with lower biases are needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Four studies reported better pain control in the PRP group (VAS) for a short time period after surgery [ 16 , 18 , 19 , 20 ]. No effect was observed in long-term follow-up.…”

Section: Resultsmentioning

confidence: 99%

Section: Arthroscopymentioning

confidence: 98%

Section: High Tibial Osteotomy (Hto)mentioning

confidence: 99%

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The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery—A Systematic Review and Meta-Analysis

Tramś

Kulinski

Kozar-Kamińska

et al. 2020

Life

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Platelet rich plasma could replace tranexemic acid in total knee replacement? A comparative study between their postoperative- bleeding hemostatic effects

Fahmy,

Yasin

2023

Current Orthopaedic Practice

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Background: The aim of the study is to detect whether platelet rich plasma (PRP) is equal to tranexemic acid (TXA) in reducing blood loss and transfusion rates following total knee arthroplasty (TKA), and compare clinical outcomes, complications, and cost effectiveness between the two groups. This is one of the first randomized, controlled trials that compare both materials in elective knee arthroplasty. Methods: 120 patients were randomized. Postoperative blood loss was determined and compared by measuring the total drainage suction together with the hemoglobin level and blood transfusion rate. Thromboembolic complications and knee society score were recorded. Results: The mean total drain output was 469 mL in the TXA group compared with 698 mL in the PRP group, with statistical significance. There were significant differences in reduction of hemoglobin level (TXA: 1.21 vs. PRP: 2.08). The rate of deep vein thrombosis (DVT) in patients given TXA was higher than those given PRP, however, there were no significant differences. No transfusions were required in either group, and no significant differences were found in the length of hospital stay, pain assessment and knee society score. Conclusions: Though the blood loss was significantly bigger in the custom-made PRP group, no transfusions were required. Meanwhile, the rate of DVT in the PRP group tends to be lower than those in TXA group. We concluded that PRP was not superior to TXA in reducing perioperative blood loss, however further large-scale randomized trials are crucial to confirm these results to be added to the calling literature.

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Intraarticular Epsilon Aminocaproic Acid Versus Tranexamic Acid in Total Knee Arthroplasty

et al. 2021

Self Cite

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Objective: To examine and compare the clinical efficacy of intraarticular epsilon aminocaproic acid (EACA) and tranexamic acid (TXA) in total knee arthroplasty (TKA). Methods: This study was a prospective, single-center, double-blinded randomized controlled trial, including sixty patients with osteoarthritis of the knee divided into two groups of 30 patients. In the TXA group, 1 g of TXA (0.05 g/ml) was applied intraarticularly, and in the EACA group, 4 g of EACA (0.2 g/ml) was applied intraarticularly. Serum hemoglobin (Hgb) and hematocrit (Htb) were measured during the preoperatively and 24 and 48 hours postoperatively. The range of motion and pain were evaluated by clinical examination. To evaluate knee function before and 2 months after surgery, the Western Ontario and McMaster Universities Index (WOMAC) questionnaire was used. Results: In total, 56 (93.3%) patients were evaluated up to the second postoperative month. No significant difference between the groups (p > 0.05) was found in the decrease in Hgb or Htb at 24 or 48 hours. Regarding assessment of the pain, WOMAC score and gain in knee flexion, no significant advantages up to 60 days after surgery (p > 0.05) were found. Conclusions: The decrease in Hgb and Htb during the first 48 hours postoperatively and the risk of transfusion were similar with the intraarticular use of 1 g of TXA and 4 g of EACA in TKA. The possible benefits regarding knee pain, gain in flexion and function were also similar for the two drugs. Level of Evidence II, Randomized, Double-Blinded, Single-Centre, Prospective Clinical Trial.

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Platelet-Rich Plasma (Prp) and Tranexamic Acid (Txa) Applied in Total Knee Arthroplasty

Cited by 4 publications

References 16 publications

The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery—A Systematic Review and Meta-Analysis

The Clinical Use of Platelet-Rich Plasma in Knee Disorders and Surgery—A Systematic Review and Meta-Analysis

Platelet rich plasma could replace tranexemic acid in total knee replacement? A comparative study between their postoperative- bleeding hemostatic effects

Intraarticular Epsilon Aminocaproic Acid Versus Tranexamic Acid in Total Knee Arthroplasty

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