Application of Tranexamic Acid in Trauma and Orthopedic Surgery

Jennings, John D; Solarz, Mark K.; Haydel, Christopher

doi:10.1016/j.ocl.2015.08.014

Cited by 52 publications

(51 citation statements)

References 42 publications

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“…39 In the literature, there are many studies that are in favor of using tranexamic acid and recommend its use to help greatly to reduce bleeding with a statistically insignifi cant risk of related side effects. [40][41][42][43][44] In relation to this, we have searched in the most authoritative scientifi c journals, studies related to our own, which would propose confl icting results with respect to ours. In particular, we searched for the safety levels of the drug in question and the risk-benefi t value.…”

Section: Resultsmentioning

confidence: 99%

Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

et al. 2018

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Section: Resultsmentioning

confidence: 99%

Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

et al. 2018

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“…Intravenous tranexamic acid has a proven track record in many orthopaedic surgeries such as total knee arthroplasty 6 - 10 , total hip arthroplasty 6 , 11 and spine surgery 12 - 14 . It is now being increasingly used in various fracture surgeries 15 - 19 . Recently local infiltration of tranexamic acid has been proven to be more effective and less harmful in total knee arthroplasty 20 , 21 .…”

Section: Introductionmentioning

confidence: 99%

Role of Local Infiltration of Tranexamic Acid in Reducing Blood Loss in Peritrochanteric Fracture Surgery in the Elderly Population

Virani¹,

Dahapute²,

Panda³

et al. 2016

MOJ

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Introduction: Peritrochanteric fractures are common injuries occurring in elderly patients. Surgeries for these fractures are associated with significant blood loss. Intravenous tranexamic acid has a proven track record in many orthopaedic surgeries including trauma, arthroplasty and spine surgeries.Objective: To study the effect of local subfascial and intramuscular infiltration of tranexamic acid in reducing blood loss and the requirement for blood transfusion in intertrochanteric fracture surgery.Study Design: Single centre prospective analytical study.Materials and Methods: One hundred and thirty seven patients above 65 years of age were included in the study, divided into two groups: the intervention group received subfascial and intramuscular infiltration of 2g tranexamic acid before wound closure and the control group of alternate patients did not receive any tranexamic acid infiltration. The postoperative drain output was recorded, as well as the haemoglobin level and the patients needing blood transfusion.Results and Conclusions: The preoperative and postoperative haemoglobin values were recorded. The mean preoperative haemoglobin was 10.9% and 10.8% (p=0.79) in the trial and control groups respectively. The mean postoperative haemoglobin was 9.5gm% and 9.2gm% (p=0.36) in the two groups. The total postoperative blood loss in the tranexamic acid group and the control group was 190.3ml and 204.3ml respectively (p=0.25). Ten patients (14.9%) in the intervention group and 12 patients (17.1%) in the control group required blood transfusion. We conclude that tranexamic acid does not play a significant role in reducing postoperative blood loss and blood transfusion when used locally in peritochanteric fracture surgery. However a larger double blinded study comparing various modalities of use of tranexamic acid is needed to conclusively establish its role.

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“…A meta-analysis by Poeran J showed that 2g TXA has the best effectiveness and safety pro le [18]. However, there is still no consensus on the optimal dosage and timing of TXA administration [19].…”

Section: Introductionmentioning

confidence: 99%

Multiple intravenous tranexamic acid doses in total knee arthroplasty in patients with rheumatoid arthritis: a randomized controlled study

Kang

Gao

et al. 2020

Preprint

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Background: To identify the efficacy and safety of multiple doses of intravenous tranexamic acid (IV-TXA) on perioperative blood loss in patients with rheumatoid arthritis (RA) who have undergone primary unilateral total knee arthroplasty (TKA).Methods: For this single-center, single-blind randomized controlled clinical trial, 10 male and 87 female participants aged 50–75 years, with RA who underwent unilateral primary TKA were recruited. The patients received one dose of 1g IV-TXA was 10 min before skin incision, followed by articular injection 1.5 g TXA after cavity suture during the surgery. The patients were randomly assigned (1:1) into two groups and received an additional single dose of IV-TXA (1 g) for 3 h (group A) or three doses of IV-TXA (1 g) for 3, 6, and 12 h (group B) postoperatively. Primary outcomes were total blood loss (TBL), hidden blood loss (HBL), and maximum hemoglobin (Hb) decrease. Secondary outcomes were transfusion rate and D-dimer levels. All parameters were measured postoperatively during inpatient hospital stay.Results: Between September 2019 and May 2020, 104 participants were randomized, but 7 were lost to follow-up. The mean TBL, HBL, and maximum Hb decrease in group B (506.1 ± 227.0 mL, 471.6 ± 224.0 mL, and 17.5 ± 7.7 g/L, respectively) were significantly lower than those in group A (608.8 ± 244.8 mL, P = 0.035; 574.0 ± 242.3 mL, P = 0.033; and 23.42 ± 9.2 g/L, P = 0.001, respectively). No episode of transfusion occurred. D-dimer level was lower in group B than in group A on postoperative day 1 (P < 0.001), and the incidence of thromboembolic events was similar between the two groups (P > 0.05). Conclusion: In patients with RA, three doses of postoperative IV-TXA further enabled HBL and Hb decrease without increasing the incidence of adverse events in a short period of time after TKA.Trial registration: The trial was registered in Chinese Clinical Trial Registry (ChiCTR1900025013).

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Application of Tranexamic Acid in Trauma and Orthopedic Surgery

Cited by 52 publications

References 42 publications

Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

Tranexamic Acid in Pertrochanteric Femoral Fracture: Is it a Safe Drug or Not?

Role of Local Infiltration of Tranexamic Acid in Reducing Blood Loss in Peritrochanteric Fracture Surgery in the Elderly Population

Multiple intravenous tranexamic acid doses in total knee arthroplasty in patients with rheumatoid arthritis: a randomized controlled study

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