Evidence map›Paper›PMID 38662002›Full record

Trial reportArchives of orthopaedic and trauma surgery2024

Comparative effectiveness of combined peri-articular and intra-articular injection versus intravenous and intra-articular injection of tranexamic acid in total knee arthroplasty: a randomized controlled trial study.

Piya Pinsornsak, Ranet Thaveekitikul, Prem Pinsornsak, Yot Tanariyakul

Abstract readRandomized Controlled TrialComparative Study
PubMed Publisher
In one paragraph

Trial report in Archives of orthopaedic and trauma surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 33% of its field
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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
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

4 authors at 1 institution in 1 country.

Piya PinsornsakDepartment of Orthopaedic Surgery, Thammasat University, 99 Moo 18 Phaholyothin Rd, Khlong Luang, Pathum Thani, 12120, Thailand.
Ranet ThaveekitikulDepartment of Orthopaedic Surgery, Thammasat University, 99 Moo 18 Phaholyothin Rd, Khlong Luang, Pathum Thani, 12120, Thailand.
Prem PinsornsakKasetsart University Laboratory School Center for Educational Research and Development, 50 Ngamwongwan Rd, Chatuchak, Bangkok, 10900, Thailand.
Yot TanariyakulDepartment of Orthopaedic Surgery, Thammasat University, 99 Moo 18 Phaholyothin Rd, Khlong Luang, Pathum Thani, 12120, Thailand. y.tanariyakul@gmail.com.ORCID http://orcid.org/0009-0004-4686-8734
Thammasat University · TH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTranexamic acid (TXA) administration is supported by numerous evidence in reducing blood loss after total knee arthroplasty (TKA). The combination of intravenous (IV) and intra-articular (IA) TXA administration revealed good result in blood loss reduction with less evidence of venous thromboembolism event (VTE). Several literature reviews portray that peri-articular (PA) administration yields similar hemostasis in comparison to IV route. However, there is no report on the clinical effect of combining PA + IA TXA in blood loss reduction and its complications, compared to combining IV + IA TXA after TKA. MATERIALS AND

methodsWe conducted a double-blind, randomized controlled trial comparing the use of PA + IA TXA administration and IV + IA TXA administration in 70 patients who were scheduled for unilateral primary TKA. Thirty-five patients were assigned for PA + IA injection (Group 1) and anoter 35 patients were assigned for IV + IA injection (Group 2). Primary outcomes included total blood loss at 48 h, and the need for blood transfusion. Secondary outcomes included thigh and leg circumference, degree of knee flexion, and postoperative complications.

resultsThe calculated blood loss at 48 h showed no difference between Groups 1 and 2 (617 ml vs. 632 ml, p = 0.425). The total hemoglobin and hematocrit changes were not different (1.89 g/dL vs. 1.97 g/dL, p = 0.371 and 5.66% vs. 5.87%, p = 0.391). There was no need for blood transfusion in either group. However, lower thigh swelling was significant in Group 1 (2.15 cm vs. 2.79 cm, p = 0.04). Leg circumferences at 48 h was also lower in Group 1 (42.12 cm vs. 42.77 cm, p = 0.04). There was no significant difference in knee flexion decrease between the two groups (38° vs. 37°, p = 0.425). There were no VTE complications or infections found in either group.

conclusionsCombined PA + IA TXA administration had similar efficacy in blood loss reduction and blood transfusion when compared to combined IV + IA TXA. The first group displayed less soft tissue swelling. The combination of PA + IA TXA administration can be used as an alternative regimen to avoid IV TXA administration.

Indexed as

Antifibrinolytic AgentsArthroplasty, Replacement, KneeBlood Loss, SurgicalTranexamic AcidAgedDouble-Blind MethodFemaleHumansInjections, Intra-ArticularInjections, IntravenousMaleMiddle AgedAntifibrinolytic AgentsTranexamic AcidBlood lossCombinedPeriarticularTotal knee arthroplastyTranexamic acid

Identifiers

PMID38662002
OpenAlexW4395450341

What OpenQuestion holds

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Registered trials

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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.