Evidence map›Paper›PMID 31351459›Full record

ArticleBMC musculoskeletal disorders2019

Intraarticular use of tranexamic acid reduces blood loss and transfusion rate after primary total knee arthroplasty.

Eric Tille, Jonas Mysliwietz, Franziska Beyer, Anne Postler, Jörg Lützner

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In one paragraph

Article in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Eric TilleUniversity Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany. eric.tille@uniklinikum-dresden.de.ORCID http://orcid.org/0000-0001-5948-6015
Jonas MysliwietzUniversity Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Franziska BeyerUniversity Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Anne PostlerUniversity Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.
Jörg LütznerUniversity Center of Orthopaedics and Traumatology, University Medicine Carl Gustav Carus Dresden, Technische Universität Dresden, Fetscherstr. 74, 01307, Dresden, Germany.

Funding

Sächsische Staats- und Landesbibliothek (SLUB) Dresden IN-1502335
6 · The paper itself

Abstract

backgroundTranexamic acid (TXA) is effective in reduction of hemorrhage after major surgical procedures. In total joint replacement it is commonly administered intravenously. Despite various studies regarding the safety of its antifibrinolytic effect there are contraindications for systemic use. In total knee arthroplasty (TKA) TXA can also be administered intraarticular. However, there is a lack of studies focusing on dosage, effectiveness and complications of this local treatment. This study aimed to evaluate if blood loss and transfusion rate can be reduced in primary TKA by local application of TXA.

methodsWe included a total of 202 consecutive primary, unilateral TKA patients, 101 without and 101 with intraartricular application of 2 g TXA. Surgery was conducted after a standardized protocol. Blood loss, transfusion and complication rates were evaluated until three months after surgery. Blood loss was estimated using the hematocrit-value (Hk) prior and five days after surgery by Rosenecher's and Mercuriali's formula.

resultsBy the use of TXA a significant reduction of blood loss (Rosencher average 1220 ml vs 1900 ml, Mercuriali average 430 ml vs 700 ml p < 0,001) and transfusion rate (0% vs 24.75% of patients, p < 0,001) was observed. There were no differences regarding complication rates. Due to the lower cost of TXA compared to applied erythrocyte concentrates a side effect of the treatment was a cost reduction of € 1.609 within this cohort.

conclusionsThe intraarticular application of 2 g TXA resulted in a significant reduction of blood loss and transfusion rate after primary TKA without increased complication rates. This method therefore seems to be a safe and cost effective instrument to reduce perioperative blood loss. However, it has to be considered that this is an off-label use.

Indexed as

AgedAntifibrinolytic AgentsArthroplasty, Replacement, KneeBlood Loss, SurgicalBlood TransfusionDose-Response Relationship, DrugFemaleHumansInjections, Intra-ArticularMaleMiddle AgedOsteoarthritis, KneePerioperative PeriodPostoperative HemorrhageProspective StudiesThromboembolismAntifibrinolytic AgentsTranexamic AcidBlood lossEndoprostheticsPrimary total knee arthroplastyRisk reductionTKATotal joint arthroplastyTranexamic acidTransfusion rateTXA

Identifiers

PMID31351459
PMCPMC6661102

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.