Comparison of the Effectiveness and Safety of Intravenous and Topical Regimens of Tranexamic Acid in Complex Tibial Plateau Fracture: A Retrospective Study

Abstract

Background Previous studies have demonstrated the effectiveness and safety of tranexamic acid (TXA) in orthopedics surgery. However, no study has investigated TXA in complex tibial plate surgery. Therefore, the purpose of this study was to confirm the safety and effectiveness of IV (intravenous) TXA and topical TXA.Material and methods This was a retrospective analysis of prospectively collected data. The control group received an equal amount of placebo (physiological saline solution); the IV group received 1.0 g TXA by intravenous injection before the tourniquet was inflated and before the surgical incision was closed, and the topical group received 3.0 g TXA in 75 mL of physiological saline solution before 5 min prior to the final tourniquet release. Perioperative blood loss, vascular events, wound complications, and adverse reactions were compared for the three groups.The pain functional and quality of life (QoL) assessment based on their corresponding scoring system.Results Baseline data were comparable for all groups. The IV group showed the best results for total blood loss (TBL) and hidden blood loss (HBL) (424.5 ± 49.4 ml, 219.3 ± 33.4 ml, respectively, all p values < 0.001). The topical group performed excellently with regard to postoperative vascular events, wound complications, and adverse reactions, but there was no statistical significant in the incidence of these between the groups. In addition, the topical group benefited in reducing postoperative pain.Conclusion This study presents the first information to show that both IV TXA and topical TXA are safe and effective for complex tibial plateau fractures. The IV regimen effectively reduced blood loss during the perioperative period, whereas the topical regimen had a better safety profile and control early postoperative pain.

Dose tranexamic acid reduce blood loss associated with simultaneous bilateral distal tibial tubercle-high tibial osteotomy?

“…Anti-brinolytic therapy, an important aspect of blood management that is considered to be closely related to the concept of enhanced recovery after surgery, has emerged as an area of particular research focus, and TXA has been apply this strategy in a clinical setting in our institution. [28][29][30][31] The safety of TXA during the perioperative period of major orthopaedic surgery has been controversial.…”

The comparative efficacies of intravenous administration and intra-articular injection of tranexamic acid during anterior cruciate ligament reconstruction for reducing postoperative hemarthrosis: A prospective randomized study

“…Tranexamic acid (TXA), as an anti brinolytic agent derived from lysine, binds to lysine receptor sites on plasminogen and prevents the formation of plasmin, thus inhibiting the breakdown of brin clots and reducing active bleeding [4]. TXA has a great role in reducing postoperative blood loss, the need for transfusion and hospital-related costs after knee surgery without increasing the surgical risks [5][6][7][8]. There are two major administration routes in the use of TXA: intravenous (IV) administration and intra-articular (IA) injection.…”