Intravenous Tranexamic Acid Has Benefit for Reducing Blood Loss after Open-Wedge High Tibial Osteotomy: A Randomized Controlled Trial

Abstract

(1) Background: the purpose of this study was to investigate the efficacy and safety of intravenous (IV) administration of tranexamic acid (TXA) in patients undergoing medial opening wedge high tibial osteotomy (MOWHTO). (2) Methods: a total of 73 patients were randomly allocated into two groups (TXA group and control group). The primary outcome was total perioperative calculated blood loss after MOWHTO. Secondary outcomes included self-reported pain severity using a 10-point visual analog scale (VAS) and the EuroQol-5 Dimension (EQ-5D) questionnaire. The postoperative allogeneic transfusion rate and wound complications were compared. Deep vein thrombosis (DVT) incidence was compared by conducting DVT computed tomography imaging. (3) Results: the total blood loss after surgery was 470.9 mL in the TXA group and 739.3 mL in the control group, showing a significant difference (p < 0.001). There were no differences in pain VAS scores between the two groups (all p > 0.05). No difference in preoperative EQ-5D scores for any items existed between the two groups. No transfusion was performed in either group. There was no difference in DVT incidence or the rate of wound complications between the two groups. (4) Conclusion: in patients undergoing MOWHTO, IV TXA reduces total blood loss and drainage amount. However, no additional benefits in clinical outcomes, transfusion rate, or wound complications were apparent, with similar DVT incidence rates.

Efficacy of intravenous tranexamic acid administration in medial opening-wedge distal tibial tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

“…The efficacy of TXA administration in reducing the amount of perioperative blood loss has been well established in various orthopedic procedures such as joint arthroplasty and spine surgery [13,14]. There have been several studies examining the efficacy and safety of TXA administration in knee osteotomies [10,15,27]. Kim et al demonstrated that the administration of TXA reduced total estimated blood loss and total amount of drainage after MOWHTO [9].…”

“…In recent years, a number of randomized controlled studies have revealed the effectiveness of TXA in reducing perioperative blood loss in patients undergoing total joint arthroplasty [13,14], and a consensus has been reached regarding its efficacy in this patient population. By contrast, there have only been two randomized controlled trials dealing with this subject in osteotomies around the knee [10,15]. Consequently, clinical evidence validating routine TXA administrations in knee osteotomies is still not robust enough.…”

Efficacy of intravenous tranexamic acid administration in medial opening wedge distal tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

“…The e cacy of TXA administration in reducing the amount of perioperative blood loss has been well established in various orthopaedic procedures such as joint arthroplasty and spine surgery [13,14]. There have been several studies examining the e cacy and safety of TXA administration in knee osteotomies [10,15,27]. Kim et al demonstrated that the administration of TXA reduced total estimated blood loss and total amount of drainage after MOWHTO [9].…”

“…By contrast,there have only been two randomized controlled trials dealing with this subject in osteotomies around the knee [10,15]. Consequently, clinical evidence validating routine TXA administrations in knee osteotomies is still not robust enough.…”

Topical Use of Low‐dose Tranexamic Acid Has no Effect on Drainage Volume after Medial Open Wedge High Tibial Osteotomy: A Case Control Study

“…Extensive soft tissue release and exposed osteotomy surface in MOWHTO can result in substantial perioperative bleeding, mean total blood loss ranged from 635.0 to 882.7 mL. [16][17][18][19] Many studies have reported TXA administration in the perioperative period of MOWHTO to reduce surgical blood loss. 16,[18][19][20][21][22] Most of the studies adopted intravenous application 18 or combination of intravenous and topical applications, 22,23 and have shown that TXA can reduce surgical blood loss in patients undergoing MOWHTO.…”