Intravenous versus intra-articular tranexamic acid in total knee arthroplasty: A double-blinded randomised controlled noninferiority trial

Knee

Volumn 23, Issue 1, 2016, Pages 152-156

  Chen, Jerry Yongqiang ^a   Chin, Pak Lin ^a   Moo, Ing How ^a   Pang, Hee Nee ^a   Tay, Darren Keng Jin ^a   Chia, Shi Lu ^a   Lo, Ngai Nung ^a   Yeo, Seng Jin ^a  

^a SINGAPORE GENERAL HOSPITAL   (Singapore)

Author keywords

Blood loss; Lower limb swelling; Total knee arthroplasty; Tranexamic acid; Transfusion

Indexed keywords

ENOXAPARIN; HEMOGLOBIN; LOW MOLECULAR WEIGHT HEPARIN; SODIUM CHLORIDE; TRANEXAMIC ACID; ANTIFIBRINOLYTIC AGENT;

ADULT; ARTICLE; BLOOD TRANSFUSION; BLOOD VOLUME; BODY MASS; CALF GIRTH; CONTROLLED STUDY; DOUBLE BLIND PROCEDURE; DRUG DOSE COMPARISON; DRUG EFFICACY; FEMALE; HUMAN; INCIDENCE; KNEE OSTEOARTHRITIS; LEG; LIMB SWELLING; MAJOR CLINICAL STUDY; MALE; OPERATION DURATION; OPERATIVE BLOOD LOSS; PERIOPERATIVE PERIOD; POSTOPERATIVE PERIOD; POSTOPERATIVE THROMBOSIS; PRIORITY JOURNAL; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; SOFT TISSUE INFLAMMATION; SUPRAPATELLA; THIGH; THROMBOSIS; THROMBOSIS PREVENTION; TOTAL KNEE REPLACEMENT; WOUND CLOSURE; ADVERSE EFFECTS; AGED; BLOOD LOSS, SURGICAL; EDEMA; FOLLOW UP; INTRAARTICULAR DRUG ADMINISTRATION; INTRAOPERATIVE PERIOD; INTRAVENOUS DRUG ADMINISTRATION; KNEE REPLACEMENT; MIDDLE AGED; OSTEOARTHRITIS, KNEE; POSTOPERATIVE COMPLICATIONS; PROCEDURES; TREATMENT OUTCOME; VERY ELDERLY;

ADMINISTRATION, INTRAVENOUS; AGED; AGED, 80 AND OVER; ANTIFIBRINOLYTIC AGENTS; ARTHROPLASTY, REPLACEMENT, KNEE; BLOOD LOSS, SURGICAL; DOUBLE-BLIND METHOD; EDEMA; FEMALE; FOLLOW-UP STUDIES; HUMANS; INJECTIONS, INTRA-ARTICULAR; INTRAOPERATIVE PERIOD; MALE; MIDDLE AGED; OSTEOARTHRITIS, KNEE; POSTOPERATIVE COMPLICATIONS; PROSPECTIVE STUDIES; TRANEXAMIC ACID; TREATMENT OUTCOME;

EID: 84958167389     PISSN: 09680160     EISSN: 18735800     Source Type: Journal    
DOI: 10.1016/j.knee.2015.09.004     Document Type: Article

References (34)

1. Abrishami A., Chung F., Wong J. Topical application of antifibrinolytic drugs for on-pump cardiac surgery: a systematic review and meta-analysis. Can J Anaesth 2009, 56(3):202-212.
2. Good L., Peterson E., Lisander B. Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement. Br J Anaesth 2003, 90(5):596-599.
3. Hippala S., Strid L., Wennerstrand M., Arvela V., Mantyla S., Ylinen J., et al. Tranexamic acid (Cyklokapron) reduces perioperative blood loss. Br J Anaesth 1995, 74(5):534-537.
4. Kalairajah Y., Simpson D., Cossey A.J., Verrall G.M., Spriggins A.J. Blood loss after total knee replacement: effects of computer-assisted surgery. J Bone Joint Surg (Br.) 2005, 87(11):1480-1482.
5. Longstaff C. Studies on the mechanisms of action of aprotinin and tranexamic acid as plasmin inhibitors and antifibrinolytic agents. Blood Coagul Fibrinolysis 1994, 5(4):537-542.
6. Ker K., Edwards P., Perel P., Shakur H., Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ 2012, 344. [e3054].
7. Dahl O.E. The role of the pulmonary circulation in the regulation of coagulation and fibrinolysis in relation to major surgery. J Cardiothorac Vasc Anesth 1997, 11(3):322-328.
8. Ekbäck G., Axelsson K., Ryttberg L., Edlund B., Kjellberg J., Weckström J., et al. Tranexamic acid reduces blood loss in total hip replacement surgery. Anesth Analg 2000, 91(5):1124-1130.
9. Rajesparan K., Biant L.C., Ahmad M., Field R.E. The effect of an intravenous bolus of tranexamic acid on blood loss in total hip replacement. J Bone Joint Surg (Br.) 2009, 91(6):776-783.
10. Alshryda S., Sukeik M., Sarda P., Blenkinsopp J., Haddad F.S., Mason J.M. A systematic review and meta-analysis of the topical administration of tranexamic acid in total hip and knee replacement. Bone Joint J 2014, 96-B(8):1005-1015.
11. Cid J., Lozano M. Tranexamic acid reduces allogeneic red cell transfusions in patients undergoing total knee arthroplasty: results of a meta-analysis of randomized controlled trials. Transfusion 2005, 45(8):1302-1307.
12. Ho K.M., Ismail H. Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: a meta-analysis. Anaesth Intensive Care 2003, 31(5):529-537.
13. Kagoma Y.K., Crowther M.A., Douketis J., Bhandari M., Eikelboom J., Lim W. Use of antifibrinolytic therapy to reduce transfusion in patients undergoing orthopedic surgery: a systematic review of randomized trials. Thromb Res 2009, 123(5):687-696.
14. Yang Z.G., Chen W.P., Wu L.D. Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am 2012, 94(13):1153-1159.
15. Maniar R.N., Kumar G., Singhi T., Nayak R.M., Maniar P.R. Most effective regimen of tranexamic acid in knee arthroplasty: a prospective randomized controlled study in 240 patients. Clin Orthop Relat Res 2012, 470(9):2605-2612.
16. Patel J.N., Spanyer J.M., Smith L.S., Huang J., Yakkanti M.R., Malkani A.L. Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty: a prospective randomized study. J Arthroplasty 2014, 29(8):1528-1531.
17. Soni A., Saini R., Gulati A., Paul R., Bhatty S., Rajoli S.R. Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty. J Arthroplasty 2014, 29(8):1525-1527.
18. Gomez-Barrena E., Ortega-Andreu M., Padilla-Eguiluz N.G., Pérez-Chrzanowska H., Figueredo-Zalve R. Topical intra-articular compared with intravenous tranexamic acid to reduce blood loss in primary total knee replacement: a double-blind, randomized, controlled, noninferiority clinical trial. J Bone Joint Surg Am 2014, 96(23):1937-1944.
19. Sarzaeem M.M., Razi M., Kazemian G., Moghaddam M.E., Rasi A.M., Karimi M. Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty. J Arthroplasty 2014, 29(8):1521-1524.
20. Seo J.G., Moon Y.W., Park S.H., Kim S.M., Ko K.R. The comparative efficacies of intra-articular and IV tranexamic acid for reducing blood loss during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2013, 21(8):1869-1874.
21. Chen J.Y., Chia S.L., Lo N.N., Yeo S.J. Intra-articular versus intravenous tranexamic acid in primary total knee replacement. Ann Transl Med 2015, 3(3):33.
22. Ishida K., Tsumura N., Kitagawa A., Hamamura S., Fukuda K., Dogaki Y., et al. Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty. Int Orthop 2011, 35(11):1639-1645.
23. Chen J.Y., Rikhraj I.S., Zhou Z., Tay D.K., Chin P.L., Chia S.L., et al. Can tranexamic acid and hydrogen peroxide reduce blood loss in cemented total knee arthroplasty?. Arch Orthop Trauma Surg 2014, 134(7):997-1002.
24. Levine B.R., Haughom B.D., Belkin M.N., Goldstein Z.H. Weighted versus uniform dose of tranexamic acid in patients undergoing primary, elective knee arthroplasty: a prospective randomized controlled trial. J Arthroplasty 2014, 29(Suppl.):186-188.
25. George D.A., Sarraf K.M., Nwaboku H. Single perioperative dose of tranexamic acid in primary hip and knee arthroplasty. Eur J Orthop Surg Traumatol 2015, 25(1):129-133.
26. Wong J., Abrishami A., El Beheiry H., Mahomed N.N., Roderick Davey J., Gandhi R., et al. Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial. J Bone Joint Surg Am 2010, 92(15):2503-2513.
27. Georgiadis A.G., Muh S.J., Silverton C.D., Weir R.M., Laker M.W. A prospective double-blind placebo controlled trial of topical tranexamic acid in total knee arthroplasty. J Arthroplasty 2013, 28(Suppl.):78-82.
28. Lisander B., Ivarsson I., Jacobsson S.A. Intraoperative autotrans- fusion is associated with modest reduction of allogeneic transfusion in prosthetic hip surgery. Acta Anaesthesiol Scand 1998, 42(6):707-712.
29. Nadler S.B., Hidalgo J.U., Bloch T. Prediction of blood volume in normal human adults. Surgery 1962, 51(4):224-232.
30. Moráis S., Ortega-Andreu M., Rodríguez-Merchán E.C., Padilla-Eguiluz N.G., Pérez-Chrzanowska H., Figueredo-Zalve R., et al. Blood transfusion after primary total knee arthroplasty can be significantly minimised through a multimodal blood-loss prevention approach. Int Orthop 2014, 38(2):347-354.
31. Ortega-Andreu M., Pérez-Chrzanowska H., Figueredo R., Gómez-Barrena E. Blood loss control with two doses of tranexamic acid in a multimodal protocol for total knee arthroplasty. Open Orthop J 2011, 5:44-48.
32. Nilsson I.M. Clinical pharmacology of aminocaproic and tranexamic acids. J Clin Pathol Suppl (Coll Pathol) 1980, 14:41-47.
33. Ahlberg A., Eriksson O., Kjellman H. Diffusion of tranexamic acid to the joint. Acta Orthop Scand 1976, 47(5):486-488.
34. Eipe N.P., Ponniah M. Perioperative blood loss assessment - how accurate?. Indian J Anaesth 2006, 50(1):35-38.