A comparative, retrospective study of peri-articular and intra-articular injection of tranexamic acid for the management of postoperative blood loss after total knee arthroplasty

Intra-articular injection of tranexamic acid (TXA) is known to be effective in controlling blood loss after total knee arthroplasty (TKA). However, this method has some disadvantages, such as TXA leakage due to soft tissue release. Peri-articular injection provides an alternative to intra-articular...

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Bibliographic Details
Published in:BMC musculoskeletal disorders 2016-10, Vol.17 (1), p.438-438, Article 438
Main Authors: Mao, Zhenyang, Yue, Bing, Wang, You, Yan, Mengning, Dai, Kerong
Format: Article
Language:English
Subjects:
Aged
Anticoagulants
Antifibrinolytic Agents - administration & dosage
Antifibrinolytic Agents - adverse effects
Antifibrinolytic Agents - therapeutic use
Arthritis
Arthroplasty, Replacement, Knee - adverse effects
Blood Transfusion - statistics & numerical data
Blood transfusions
Complications and side effects
Drainage
Drug dosages
Drug therapy
Female
Hemoglobins - analysis
Hemorrhage
Hospitals
Humans
Injections, Intra-Articular
Joint replacement surgery
Knee
Knee Joint - surgery
Male
Middle Aged
Musculoskeletal diseases
Operative Time
Osteoarthritis, Knee - surgery
Performance evaluation
Postoperative Care - methods
Postoperative Hemorrhage - prevention & control
Prostheses
Retrospective Studies
Surgeons
Thromboembolism - chemically induced
Thromboembolism - epidemiology
Time Factors
Tranexamic acid
Tranexamic Acid - administration & dosage
Tranexamic Acid - adverse effects
Tranexamic Acid - therapeutic use
Venous Thrombosis - chemically induced
Venous Thrombosis - epidemiology
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Summary:Intra-articular injection of tranexamic acid (TXA) is known to be effective in controlling blood loss after total knee arthroplasty (TKA). However, this method has some disadvantages, such as TXA leakage due to soft tissue release. Peri-articular injection provides an alternative to intra-articular administration of TXA. This study aimed to evaluate the effects of peri-articular injection of TXA in reducing blood loss after TKA and compare them to those of intra-articular TXA injection. This was a retrospective analysis of 127 patients who underwent primary, unilateral TKA for knee osteoarthritis in our hospital between January 2014 and December 2014. Cases were classified into 3 comparison groups: 49 patients in the peri-articular TXA group, 36 in the intra-articular group, and 42 in the control group (TXA not administered). Demographic variables, hemoglobin (Hb) measured before and after surgery, operation time, total amount of drained volume, time of removing drains, units of blood transfused peri- and postoperatively, estimated volume of blood loss, and preoperative comorbidities were retrieved from the patients' medical charts. Statistical analyses were performed using SPSS 19.0 software. There were no significant differences of demographic variables and operation time among three groups (P > 0.05). Compared to the control group, both TXA groups had a significantly reduced volume of blood loss, postoperative knee joint drainage, hemoglobin concentration, time of removing drains, and need for blood transfusion (P  0.05). There were no deep venous thrombosis or thromboembolic complications in any group. Peri-articular injection of TXA is as effective as an intra-articular injection in reducing postoperative blood loss during TKA. Both methods had a statistically significant benefit in reducing the change in Hb concentration, volume of joint drainage, and estimated volume of blood loss when compared to the control group. Peri-articular injection of TXA can significantly reduce the blood transfusion rate compared to the control group.
ISSN:1471-2474
1471-2474
DOI:10.1186/s12891-016-1293-3