Combined intra-articular and intravenous tranexamic acid reduces blood loss in total knee arthroplasty a randomized, double-blind, placebo-controlled trial

Journal of Bone and Joint Surgery - American Volume

Volumn 98, Issue 10, 2016, Pages 835-841

  Nielsen, Christian Skovgaard ^a,b   Jans, Øivind ^c,d   Ørsnes, Thue ^a   Foss, Nicolai Bang ^a   Troelsen, Anders ^a,d   Husted, Henrik ^a,d  

^a Mental Health Center Glostrup   (Denmark)

^b MASSACHUSETTS GENERAL HOSPITAL   (United States)

^c University of Copenhagen   (Denmark)

^d Lundbeck Foundation Centre for Fast Track Hip and Knee Arthroplasty   (Denmark)

Author keywords

[No Author keywords available]

Indexed keywords

HEMOGLOBIN; PLACEBO; SODIUM CHLORIDE; TRANEXAMIC ACID; ANTIFIBRINOLYTIC AGENT;

ADULT; AGED; ARTICLE; BLOOD TRANSFUSION; CONTROLLED STUDY; DILUTION; DOUBLE BLIND PROCEDURE; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; POSTOPERATIVE HEMORRHAGE; PREOPERATIVE PERIOD; PRIORITY JOURNAL; RANDOMIZED CONTROLLED TRIAL; STANDARD; THROMBOEMBOLISM; TOTAL KNEE ARTHROPLASTY; TREATMENT OUTCOME; BLOOD LOSS, SURGICAL; INTRAARTICULAR DRUG ADMINISTRATION; KNEE REPLACEMENT; MIDDLE AGED; OSTEOARTHRITIS, KNEE;

AGED; ANTIFIBRINOLYTIC AGENTS; ARTHROPLASTY, REPLACEMENT, KNEE; BLOOD LOSS, SURGICAL; BLOOD TRANSFUSION; DOUBLE-BLIND METHOD; FEMALE; HUMANS; INJECTIONS, INTRA-ARTICULAR; MALE; MIDDLE AGED; OSTEOARTHRITIS, KNEE; POSTOPERATIVE HEMORRHAGE; THROMBOEMBOLISM; TRANEXAMIC ACID;

EID: 84978924518     PISSN: 00219355     EISSN: 15351386     Source Type: Journal    
DOI: 10.2106/JBJS.15.00810     Document Type: Article

References (36)

1. Husted H. Fast-track hip and knee arthroplasty: clinical and organizational aspects. Acta Orthop Suppl. 2012 Oct;83(346):1-39.
2. Hu S, Zhang ZY, Hua YQ, Li J, Cai ZD. A comparison of regional and general anaesthesia for total replacement of the hip or knee: a meta-analysis. J Bone Joint Surg Br. 2009 Jul;91(7):935-42.
3. Charalambides C, Beer M, Melhuish J, Williams RJ, Cobb AG. Bandaging technique after knee replacement. Acta Orthop. 2005 Feb;76(1):89-94.
4. Alshryda S, Sarda P, Sukeik M, Nargol A, Blenkinsopp J, Mason JM. Tranexamic acid in total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Br. 2011 Dec;93(12):1577-85.
5. Raveendran R, Wong J. Tranexamic acid: more evidence for its use in joint replacement surgery. Transfusion. 2014 Jan;54(1):2-3.
6. Zhang H, Chen J, Chen F, Que W. The effect of tranexamic acid on blood loss and use of blood products in total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2012 Sep;20(9):1742-52. Epub 2011 Nov 8.
7. Roy SP, Tanki UF, Dutta A, Jain SK, Nagi ON. Efficacy of intra-articular tranexamic acid in blood loss reduction following primary unilateral total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2494-501. Epub 2012 Mar 15.
8. Nilsson IM. Clinical pharmacology of aminocaproic and tranexamic acids. J Clin Pathol Suppl (R Coll Pathol). 1980;14:41-7.
9. Ker K, Prieto-Merino D, Roberts I. Systematic review, meta-analysis and meta-regression of the effect of tranexamic acid on surgical blood loss. Br J Surg. 2013 Sep;100(10):1271-9. Epub 2013 Jul 9.
10. Poeran J, Rasul R, Suzuki S, Danninger T, Mazumdar M, Opperer M, Boettner F, Memtsoudis SG. Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety. BMJ. 2014;349(August):g4829. Epub 2014 Aug 12.
11. Wong J, Abrishami A, El Beheiry H, Mahomed NN, Roderick Davey J, Gandhi R, Syed KA, Muhammad Ovais Hasan S, De Silva Y, Chung F. Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial. J Bone Joint Surg Am. 2010 Nov 3;92(15):2503-13.
12. Zhao-Yu C, Yan G, Wei C, Yuejv L, Ying-Ze Z. Reduced blood loss after intra-articular tranexamic acid injection during total knee arthroplasty: a meta-analysis of the literature. Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12):3181-90. Epub 2013 Dec 19.
13. Gomez-Barrena E, Ortega-Andreu M, Padilla-Eguiluz NG, 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 Dec 3;96(23): 1937-44.
14. Gebhard F, Huber-Lang M. Polytrauma-pathophysiology and management principles. Langenbecks Arch Surg. 2008 Nov;393(6):825-31. Epub 2008 Apr 23.
15. Maniar RN, Kumar G, Singhi T, Nayak RM, Maniar PR. Most effective regimen of tranexamic acid in knee arthroplasty: a prospective randomized controlled study in 240 patients. Clin Orthop Relat Res. 2012 Sep;470(9):2605-12. Epub 2012 Mar 15.
16. Ishida K, Tsumura N, Kitagawa A, Hamamura S, Fukuda K, Dogaki Y, Kubo S, Matsumoto T, Matsushita T, Chin T, Iguchi T, Kurosaka M, Kuroda R. Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty. Int Orthop. 2011 Nov;35(11):1639-45. Epub 2011 Jan 21.
17. Karaaslan F, Karaoglu S, Mermerkaya MU, Baktir A. Reducing blood loss in simultaneous bilateral total knee arthroplasty: combined intravenous-intra-articular tranexamic acid administration. A prospective randomized controlled trial. Knee. 2015 Mar;22(2):131-5. Epub 2014 Dec 13.
18. Lin SY, Chen CH, Fu YC, Huang PJ, Chang JK, Huang HT. The efficacy of combined use of intraarticular and intravenous tranexamic acid on reducing blood loss and transfusion rate in total knee arthroplasty. J Arthroplasty. 2015 May;30(5): 776-80. Epub 2014 Dec 5.
19. Andersen LØ, Kehlet H. Analgesic efficacy of local infiltration analgesia in hip and knee arthroplasty: a systematic review. Br J Anaesth. 2014 Sep;113(3):360-74. Epub 2014 Jun 17.
20. Gross JB. Estimating allowable blood loss: corrected for dilution. Anesthe-siology. 1983 Mar;58(3):277-80.
21. Nadler SB, Hidalgo JH, Bloch T. Prediction of blood volume in normal human adults. Surgery. 1962 Feb;51(2):224-32.
22. Hourlier H, Reina N, Fennema P. Single dose intravenous tranexamic acid as effective as continuous infusion in primary total knee arthroplasty: a randomised clinical trial. Arch Orthop Trauma Surg. 2015 Apr;135(4):465-71. Epub 2015 Feb 10.
23. Harrap RS, Whyte GS, Farrugia A, Jones C. Some characteristics of blood shed into the Solcotrans postoperative orthopaedic drainage/reinfusion system. Med J Aust. 1992 Jul 20;157(2):95-6.
24. Husted H, Gromov K, Malchau H, Freiberg A, Gebuhr P, Troelsen A. Traditions and myths in hip and knee arthroplasty. Acta Orthop. 2014 Dec;85(6):548-55. Epub 2014 Oct 6.
25. Ejaz A, Laursen AC, Kappel A, Laursen MB, Jakobsen T, Rasmussen S, Nielsen PT. Faster recovery without the use of a tourniquet in total knee arthroplasty. Acta Orthop. 2014 Aug;85(4):422-6. Epub 2014 Jun 23.
26. Ledin H, Aspenberg P, Good L. Tourniquet use in total knee replacement does not improve fixation, but appears to reduce final range of motion. Acta Orthop. 2012 Oct;83(5):499-503. Epub 2012 Sep 14.
27. Holm B, Kristensen MT, Bencke J, Husted H, Kehlet H, Bandholm T. Loss of knee-extension strength is related to knee swelling after total knee arthroplasty. Arch Phys Med Rehabil. 2010 Nov;91(11):1770-6.
28. Alcelik I, Pollock RD, Sukeik M, Bettany-Saltikov J, Armstrong PM, Fismer P. A comparison of outcomes with and without a tourniquet in total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials. J Arthroplasty. 2012 Mar;27(3):331-40. Epub 2011 Sep 22.
29. Zhang W, Li N, Chen S, Tan Y, Al-Aidaros M, Chen L. The effects of a tourniquet used in total knee arthroplasty: a meta-analysis. J Orthop Surg Res. 2014;9(1):13. Epub 2014 Mar 6.
30. Molt M, Harsten A, Toksvig-Larsen S. The effect of tourniquet use on fixation quality in cemented total knee arthroplasty a prospective randomized clinical controlled RSA trial. Knee. 2014 Mar;21(2):396-401. Epub 2013 Oct 24.
31. Petäjä J, Myllynen P, Myllylä G, Vahtera E. Fibrinolysis after application of a pneumatic tourniquet. Acta Chir Scand. 1987 Nov-Dec;153(11-12):647-51.
32. Soni A, Saini R, Gulati A, Paul R, Bhatty S, Rajoli SR. Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty. J Arthroplasty. 2014 Aug;29(8):1525-7. Epub 2014 Apr 5.
33. Konig G, Hamlin BR, Waters JH. Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty. J Arthroplasty. 2013 Oct; 28(9):1473-6. Epub 2013 Jul 23.
34. Mannucci PM. Hemostatic drugs. N Engl J Med. 1998 Jul 23;339(4):245-53.
35. Benoni G, Fredin H, Knebel R, Nilsson P. Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in forty primary operations. Acta Orthop Scand. 2001 Oct;72(5):442-8.
36. Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, Gogichaishvili T, Gupta S, Herrera J, Hunt B, Iribhogbe P, Izurieta M, Khamis H, Komolafe E, Marrero MA, Mejía-Mantilla J, Miranda J, Morales C, Olaomi O, Olldashi F, Perel P, Peto R, Ramana PV, Ravi RR, Yutthakasemsunt S; CRASH-2 trial collaborators. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010 Jul 3;376(9734):23-32. Epub 2010 Jun 14.