Tranexamic acid is beneficial for blood management of high tibial osteotomy: a randomized controlled study

Ni, Jingen; Liu, Juan; Zhang, Jing; José, Juán; Dang, Xiaoqian; Shi, Zhibin

doi:10.1007/s00402-020-03558-5

Cited by 17 publications

(50 citation statements)

References 48 publications

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“…Research on the use of IV TXA in TKA has been actively conducted, and, in fact, a consensus has been established for the use of IV TXA in TKA [ 18 , 32 , 33 , 34 ]. However, research on the use of IV TXA when implementing MOWHTO remains sparse [ 5 , 7 , 8 , 14 ]. We are aware of only one prospective RCT that compared TXA and placebo therapy in patients undergoing HTO.…”

Section: Discussionmentioning

confidence: 99%

“…We are aware of only one prospective RCT that compared TXA and placebo therapy in patients undergoing HTO. One RCT and three retrospective studies did not clearly provide the basis for the use of IV TXA in patients undergoing MOWHTO [ 5 , 7 , 8 , 14 ]. The abovementioned RCT lacked data for the safety of DVT occurrence [ 7 ] ( Table 4 ).…”

Section: Discussionmentioning

confidence: 99%

“…Among HTO techniques, medial opening wedge HTO (MOWHTO) has become more popular than closing wedge HTO in recent years because of the simplicity of surgery [ 3 , 4 , 5 ]. However, in the case of MOWHTO, major bleeding can occur because the medullary cavity is opened during the osteotomy [ 6 ], and only subcutaneous tissue and skin prevent postoperative bleeding from occurring [ 7 , 8 ]. Rates of wound complications, such as hematoma, wound dehiscence, or superficial soft-tissue infection have been reported to be as high as 5% to 10% among MOWHTO patients [ 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, data supporting the routine use of TXA in MOWHTO with respect to the administration method and adverse effects are insufficient in comparison with available data regarding arthroplasty [ 5 , 7 , 8 , 10 , 14 ]. Most existing studies are retrospective [ 5 , 8 , 10 , 14 ] and no RCT has clearly assessed the incidence of deep vein thrombosis (DVT) following MOWHTO when using TXA [ 7 ]. The purpose of this study was therefore to investigate the efficacy and safety of IV administration of TXA in patients undergoing MOWHTO.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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

Kim

Koh

Sung

et al. 2021

JCM

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(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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Kim

Koh

Sung

et al. 2021

JCM

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“…Medial opening wedge high tibial osteotomy (HTO) is an established treatment for medial compartment knee osteoarthritis with varus deformity [1]. As joint preservation surgery, the procedures is intended to restoring the mechanical axis of the lower limb, transferring the load from medial compartment onto the non-affected lateral compartment, and subsequently delay osteoarthritis progression [2]. Many surgeons will routinely perform laboratory tests within 3 days after major orthopedic surgery.…”

Section: Introductionmentioning

confidence: 99%

Are Routine Postoperative Laboratory Tests Really Necessary after High Tibial Osteotomy surgery?

Nie

Lan

et al. 2021

Preprint

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Background: The purpose of this study was to assess the necessity and cost-effectiveness of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery.Methods: A prospective study was conducted and 513 patients with symptomatic isolated medial compartment osteoarthritis received HTO surgery from January 2015 to May 2020 were included in this study. The associations between different clinical factors and postoperative clinical treatment were analyzed. Finally, A logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results: In this study, 482 patients had completed the full set of postoperative laboratory studies within 3 days after surgery were included in the present study. However, only a small proportion of the patients with anemia (3.9%), hypoalbuminemia (4.1%), and abnormal serum potassium levels (3.5%) required clinical intervention after surgery. Binary logistic regression model analysis showed that body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative time were the independent risk factors correlated with postoperative blood transfusion in patients with HTO surgery. Female gender and preoperative albumin level were independent risk factors for patients who had requiring albumin supplementation after HTO surgery. Finally, preoperative potassium was the independent risk factors for patients required potassium supplementation postoperatively.Conclusions: based on the analysis, we conclude that routinely ordering postoperative laboratory studies after HTO surgery are both unnecessary and cost inefficient. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.

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The use of tranexamic acid reduces blood loss in osteotomy at knee level: a systematic review

Bierke

Häner

Bentzin

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Aim of this systematic review was to evaluate the literature regarding the efect of tranexamic acid (TXA) on the outcome after knee osteotomy. Methods A systematic literature search was carried out in various databases on studies on the use of tranexamic acid in osteotomies around the knee. Primary outcome criterion was the hemoglobin (drop). Secondary outcome criteria were total blood loss, drainage volume, adverse efects such as thromboembolic events, blood transfusions, wound complications and clinical scores. A meta-analysis was performed for quantitative measures. The present study was registered prospectively (www. crd. york. ac. uk/ PROSP ERO; no.: CRD42021229624). Results Seven studies with 584 patients (TXA group: 282 patients, non TXA group: 302 patients) Hemoglobin decrease (1.54 g/dl vs. 2.28 g/dl), blood loss (394.49 ml vs. 595.54 ml) and drainage volume (266.5 ml vs. 359.05 ml) were signiicantly less in the TXA group compared to the non TXA group. No thromboembolic event was noted in any study. In the non TXA group four blood transfusions were given. Eleven wound complications occurred in the non TXA group in comparison to two wound complications in the TXA group. ConclusionsThe results of the present study show that the application of TXA reduces hemoglobin drop, blood loss and drainage volume. These efects could be responsible for the lesser rate of side efects after administration of TXA during knee osteotomy. KeywordsHigh tibial osteotomy • Medial open wedge osteotomy • Distal femoral osteotomy • HTO • DFO • Osteotomy and tranexamic acid * Wolf Petersen

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Tranexamic acid is beneficial for blood management of high tibial osteotomy: a randomized controlled study

Cited by 17 publications

References 48 publications

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

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

Are Routine Postoperative Laboratory Tests Really Necessary after High Tibial Osteotomy surgery?

The use of tranexamic acid reduces blood loss in osteotomy at knee level: a systematic review

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