Tranexamic Acid Does Not Reduce the Risk of Transfusion in Rheumatoid Arthritis Patients Undergoing Total Joint Arthroplasty

Morse, Kyle W.; Heinz, Nicole; Abolade, Jeremy M.; Wright-Chisem, Joshua; Russell, Linda; Zhang, Meng; Mirza, Serene; Orange, Dana E.; Figgie, Mark P.; Sculco, Peter K.; Goodman, Susan M.

doi:10.1016/j.arth.2020.04.029

Cited by 16 publications

(23 citation statements)

References 30 publications

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“…The 3 conclusions from our study were that increased operative time, decreased preoperative hemoglobin, and increased preoperative disease activity correlated with risk of postoperative transfusion [1]. Preoperative optimization and planning should include assessment of joint deformity and its impact on postoperative transfusion requires further investigation.…”

Section: Response To Letter To the Editor On: Tranexamic Acid Does Nomentioning

confidence: 71%

“…As such, the reporting and analysis of tourniquet usage is challenging. Similarly, the use of surgical drains is variable at our institution and we acknowledge that this is a limitation of the study [1]. We also did not collect thromboembolic prophylaxis.…”

Section: Response To Letter To the Editor On: Tranexamic Acid Does Nomentioning

confidence: 99%

“…We appreciate the opportunity to dialog with Yayac et al [1] regarding their recent Journal of Arthroplasty paper, which explored the effectiveness of physical therapy (PT) postarthroplasty. It is our hope that this discussion will facilitate continued study in this important area.…”

Section: Letter To the Editor On: Formal Physical Therapy Following Tmentioning

confidence: 99%

“…Yayac et al [1] conducted a quasi-experimental study of the effects of PT vs no PT following primary hip or knee arthroplasty on a variety of outcomes. More specifically, the investigators used a non-equivalent group design [2] and retrospectively collected data to compare post-acute care outcomes among patients referred to one of the 4 groups: (1) outpatient PT, (2) home-based PT, (3) combination of outpatient and home-based PT, and (4) no PT.…”

Section: Letter To the Editor On: Formal Physical Therapy Following Tmentioning

confidence: 99%

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Response to Letter to the Editor on: Tranexamic Acid Does Not Reduce the Risk of Transfusion in Rheumatoid Arthritis Patients Undergoing Total Joint Arthroplasty

Morse

Heinz

Abolade

et al. 2020

The Journal of Arthroplasty

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Section: Response To Letter To the Editor On: Tranexamic Acid Does Nomentioning

confidence: 71%

Section: Response To Letter To the Editor On: Tranexamic Acid Does Nomentioning

confidence: 99%

Section: Letter To the Editor On: Formal Physical Therapy Following Tmentioning

confidence: 99%

Section: Letter To the Editor On: Formal Physical Therapy Following Tmentioning

confidence: 99%

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Response to Letter to the Editor on: Tranexamic Acid Does Not Reduce the Risk of Transfusion in Rheumatoid Arthritis Patients Undergoing Total Joint Arthroplasty

Morse

Heinz

Abolade

et al. 2020

The Journal of Arthroplasty

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“…Many studies have shown that repeated administration of postoperative TXA (mainly in OA patients) is not associated with an increased risk of venous thromboembolic events [15,33,34]. Tzatzairis et al [35] showed that during TKA without the use of tourniquet, three doses of perioperative IV-TXA(15mg/kg) reduced blood loss, Hb decrease, and transfusion rate, and led to faster rehabilitation.…”

Section: Discussionmentioning

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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More complications and higher transfusion rate in patients with rheumatoid arthritis than osteoarthritis undergoing total hip arthroplasty

Jiang

Xu²,

Wang³

et al. 2023

International Orthopaedics (SICOT)

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Tranexamic Acid Does Not Reduce the Risk of Transfusion in Rheumatoid Arthritis Patients Undergoing Total Joint Arthroplasty

Cited by 16 publications

References 30 publications

Response to Letter to the Editor on: Tranexamic Acid Does Not Reduce the Risk of Transfusion in Rheumatoid Arthritis Patients Undergoing Total Joint Arthroplasty

Response to Letter to the Editor on: Tranexamic Acid Does Not Reduce the Risk of Transfusion in Rheumatoid Arthritis Patients Undergoing Total Joint Arthroplasty

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

More complications and higher transfusion rate in patients with rheumatoid arthritis than osteoarthritis undergoing total hip arthroplasty

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