Combined Administration of IV and Topical Tranexamic Acid is Not Superior to Either Individually in Primary Navigated TKA

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• 作者：Eun-Kyoo Song ; MD ; PhD^a ; Jong-Keun Seon ; MD ; PhD^a ; Jatin Prakash ; MS(ortho)^a ; ; Young-Jun Seol ; MD(ortho)^b ; Yong Jin Park ; MD^a ; Cheng Jin ; MD(ortho)^a
• 关键词：tranexamic acid ; combined ; IV ; topical ; randomized control trial ; primary navigation total knee arthroplasty
• 刊名：The Journal of Arthroplasty
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：32
• 期：1
• 页码：37-42
• 全文大小：410 K
• 卷排序：32

文摘

In this study, we tried to assess if combined method (intravenous [IV] and topical) of tranexamic acid (TXA) administration, which has been shown to be superior in conventional arthroplasty, has similar effect in navigational arthroplasty compared to administration of drug either individually.MethodsIn present randomized control trial, 200 patients were randomly divided in one of the 4 groups using computer-generated tables—control, IV, intraarticular, and combined. We studied evident loss through drain, total loss based on Gross method and hemoglobin balance method, hidden losses, hemoglobin and hematocrit drop, functional scores, and all possible complications related to TXA.ResultsEvident loss in combined group was 535.55 mL, not significantly less than IV (585 mL, P = .15) and intraarticular group (514 mL, P = .74). However, these were significantly less than control group (696 mL, P = .000). Functional scores and recovery rates were, however, comparable in all 4 groups. No patients in any group developed symptomatic deep vein thrombosis.ConclusionTranexamic use decreases blood loss in navigation-assisted arthroplasty, however, less than that observed for conventional arthroplasty in literature. Further, combined group has no added advantage over other methods of drug administration. We believe that additional amount of TXA administered in combined regimen may not be clinically useful. Further TXA group did not have any advantage in terms of functional recovery over control group.