Publication: Efficacy of low-dose intra-articular tranexamic acid in total knee replacement; a prospective triple-blinded randomized controlled trial
Issued Date
2013
Resource Type
Language
eng
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
BMC Musculoskeletal Disorders. Vol. 14, (2013), 340
Suggested Citation
Paphon Sa-ngasoongsong, Siwadol Wongsak, Pongsthorn Chanplakorn, Patarawan Woratanarat, Supaporn Wechmongkolgorn, Bussanee Wibulpolprasert, Pornchai Mulpruek, Viroj Kawinwonggowit Efficacy of low-dose intra-articular tranexamic acid in total knee replacement; a prospective triple-blinded randomized controlled trial. BMC Musculoskeletal Disorders. Vol. 14, (2013), 340. doi:10.1186/1471-2474-14-340 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/2701
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Efficacy of low-dose intra-articular tranexamic acid in total knee replacement; a prospective triple-blinded randomized controlled trial
Abstract
Background: Recently, a number of studies using intra-articular application of tranexamic acid (IA-TXA), with
different dosage and techniques, successfully reduced postoperative blood loss in total knee replacement (TKR).
However, best of our knowledge, the very low dose of IA-TXA with drain clamping technique in conventional TKR
has not been yet studied. This study aimed to evaluate the effectiveness and dose-response effect of two low-dose
IA-TXA regimens in conventional TKR on blood loss and blood transfusion reduction.
Methods: Between 2010 and 2011, a triple-blinded randomized controlled study was conducted in 135 patients
undergoing conventional TKR. The patients were allocated into three groups according to intra-articular solution
received: Control group (physiologic saline), TXA-250 group (TXA 250 mg), and TXA-500 group (TXA 500 mg). The
solution was injected after wound closure followed by drain clamping for 2 hours. Blood loss and transfusion were
recorded. Duplex ultrasound was performed. Functional outcome and complication were followed for one year.
Results: There were forty-five patients per groups. The mean total hemoglobin loss was 2.9 g/dL in control group
compared with 2.2 g/dL in both TXA groups (p > 0.001). Ten patients (22%, control), six patients (13%, TXA-250) and
none (TXA-500) required transfusion (p = 0.005). Thromboembolic events were detected in 7 patients (4 controls, 1
TXA-250, and 2 TXA-500). Functional outcome was non-significant difference between groups.
Conclusions: Combined low-dose IA-TXA, as 500 mg, with 2-hour clamp drain is effective for reducing postoperative
blood loss and transfusion in conventional TKR without significant difference in postoperative knee function or
complication.