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Efficacy of Combined Use of Intravenous and Topical versus only Topical Tranexamic Acid in Primary Total Knee Arthroplasty
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| Author:
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ELAF MAHMOOD SHIHAB, SAJA MAJEED SHAREEF, SABA NASEER ABBAS, MAHMOOD SHIHAB WAHHAB, NAWAR NEMA YASEEN
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| Abstract:
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Background: Total knee arthroplasty (TKA) is one of the major orthopedic procedures that is associated with significant amount of blood loss. Different methods were introduced to reduce the risk of intra- and postoperative bleeding including the use of topical and/or intravenous tranexamic acid injection.
Objective: Comparing the efficacy of combined intravenous and topical versus only topical tranexamic acid injection in reducing the postoperative blood loss and the need for blood transfusion in patients undergoing primary total knee arthroplasty.
Patients and methods: Between April 2015 and October 2015, 30 patients with primary osteoarthritis and rheumatoid arthritis who underwent a unilateral cemented primary TKA, were included in a prospective randomized controlled trial study in Medical City/ Hospital of Specialized Surgeries. Patients were divided into 2 groups; Group A, administered topical tranexamic acid (15 patients), and Group B, administered combined topical and intravenous tranexamic acid (15 patients). The total volume of drained blood at 6 hours, 24 hours and 48 hours postoperatively and the change in hemoglobin and hematocrit 48 hours postoperatively were recorded. Blood transfusions were recorded as the number of transfused units of cross-matched whole blood.
Results: In group A, the mean postoperative hemoglobin and hematocrit was 9.97 g/dl and 30.81% respectively. In Group B, the mean postoperative hemoglobin and hematocrit was 10.72 g/dl and 32.40% respectively. In Group A, the total drain blood loss was 9375 ml. In Group B, the total drain blood loss was 9325 ml. In both groups, 4 patients from each (26.67%) required blood transfusion.
Conclusions: The combined intravenous and topical TXA administration in primary TKA showed similar efficacy and safety to the only topical administration regarding the postoperative hemoglobin, hematocrit, drain blood loss, and the blood transfusion rate.
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| Keyword:
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Tranexamic acid, Total Knee Arthroplasty, postoperative blood loss
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| EOI:
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-
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| DOI:
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https://doi.org/10.31838/ijpr/2021.13.02.523
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| Download:
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