The effects of a new protocol on blood loss in total knee arthroplasty

Abstract

The aim of study was to evaluate the efficacy of blood loss prevention with Tranexamic acid in patients undergoing total knee arthroplasty (TKA). The Authors defined a new protocol that foresees the use of Tranexamic acid both pre-intra and post-operatively. Seventy patients indicated for TKA were enrolled. Thirty-five patients (control group) followed standard protocol without Tranexamic acid and the other 35 patients (study group) followed standard protocol with Tranexamic acid. We analyzed the values of hemoglobin (Hb), hematocrit (HCT) and red blood cells (RBCs) both pre-operatively (T0) and post-operatively: immediately after surgery (T1), at one day (T2) and three days post-op (T3). We observed statistical differences at T0 and T3 regarding the Hb, HT and RBCs value between the two groups. Moreover, 11.4% in the study and 28.5% in the control group required blood transfusion. No thrombotic or thrombo-embolic events were reported. We conclude that Tranexamic acid use, as in our protocol, reduces postoperative bleeding in primary knee arthroplasty, with the absence of thrombo-embolic events.

Early Posttraumatic Antifibrinolysis Reduces Perioperative Hidden Blood Loss in Elderly Patients with an Intertrochanteric Fracture: A Randomized Controlled Trial

“…However, there is no direct evidence linking TXA to the increased risk of thrombosis thus far. In contrast, abundant clinical studies have confirmed the safety of the application of TXA, not only to patients undergoing elective TJA or TKA [33][34][35][36][37] but also to acute trauma patients [29], including hip fracture patients [14][15][16][17][18]. Similarly, the present study also did not find any increased risk of thrombosis in patients who received posttraumatic antifibrinolysis.…”

Hidden blood loss of minimally invasive hybrid lumbar interbody fusion: an analysis of influencing factors

“…Tranexamic acid, a frequently used haemostatic drug in orthopedic surgery, has been widely employed in spinal surgery to reduce intraoperative bleeding and hidden blood loss with the absence of thrombo-embolic events [ 27 , 28 ]. The current study focuses on the use of tranexamic acid in posterior spinal fusion, mainly by intravenous drip and topical application; Zhinan Ren [ 29 ] applied a topical tranexamic acid dip (1 g tranexamic acid in 100 mL saline solution) for 5 minutes before wound closure and showed a significant reduction in postoperative invisible blood loss, similar to the findings of Shi [ 30 ] et al On the other hand, Zhu [ 31 ] advocated one intravenous dose of tranexamic acid 30 min before surgery and one dose 3 h after the start of surgery, while Zheng [ 32 ] suggested a combination of intravenous drip and topical application to reduce intraoperative bleeding.…”

Comparison of 2 different fixation techniques of comminuted acetabular quadrilateral surface fractures using square bracket-shaped tubular plate or interfragmentary screws in addition to supra/infrapectineal plate fixation: An observational study

“…Tranexamic acid, which is also used in other major orthopedic surgeries, can be utilized to reduce the amount of bleeding in acetabular fixation surgeries. [ 19 ] Considering this, the SBST plate technique reduces the fracture by acting like a collinear clamp and also provides a buttress effect similar to the buttress screw technique in the study by Karim et al without disturbing the adjacent anatomical structures. [ 12 ]…”