ArticleIndian journal of orthopaedics2022
Should We Use Intra-articular Tranexamic Acid Before or After Capsular Closure During Total Knee Replacement? A Study of 100 Knees.
Article in Indian journal of orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIntraarticular (IA) administration of tranexamic acid (TXA) is a proven way of reducing blood loss in total knee replacement (TKR). However, different methods of administration have been described in literature such as placement of an intra-articular swab soaked in TXA before capsular closure or injecting TXA intraarticularly after capsular closure. We decided to compare these two methods. MATERIALS AND
methodsOne hundred consecutive patients planned for unilateral TKR between December 2018 and March 2019 were selected for the study and divided into 2 groups of 50 patients each. All patients received IV and oral TXA identically-15 mg/kg TXA IV preoperatively, 10 mg/kg IV TXA at 3 and 6 h postoperatively, and 1 g oral TXA for the next 2 days. Group A was given IA TXA via swab soaked with 1 g TXA in 100 ml normal saline (NS) before closure of arthtrotomy, while Group B was given 1 g of IA TXA via injection in the knee after capsular closure. Preoperative haemoglobin (Hb) and postoperative day 4 Hb values were measured. Blood loss was calculated and compared in both groups using Mann Whitney test.
resultThe mean blood loss was 652.23 ± 64.36 ml in Group A and 542.68 ± 266.23 ml in Group B. The difference in blood loss between both groups was found to be clinically significant with a
conclusionInjecting TXA intraarticularly after capsular closure is more effective than using an intra-articular swab containing TXA. LEVEL OF EVIDENCE: Level III Retrospective Comparative study.
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