Evidence map›Paper›PMID 40355919›Full record

Trial reportJournal of orthopaedic surgery and research2025

Perioperative blood loss of sequential administration of hemocoagulase Agkistrodon and Tranexamic acid for primary total knee arthroplasty: a randomized controlled trial.

Yucan Ju, Huansheng Liu, Wenyu Jiang, Qiang Huang, Zongke Zhou, Fuxing Pei

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

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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

2 citing papers in PubMed.

  1. Review
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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

6 authors.

Yucan Ju *Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, The People's Republic of China.
Huansheng Liu *Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, The People's Republic of China.
Wenyu JiangDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, The People's Republic of China.
Qiang HuangDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, The People's Republic of China. huangqiang4325@126.com.
Zongke ZhouDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, The People's Republic of China.
Fuxing PeiDepartment of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan Province, The People's Republic of China.

Funding

1·3·5 project for disciplines of excellence-Clinical Research Fund, West China Hospital, Sichuan University 2023HXFH013Sichuan Province Natural Science Fund 2024NSFSC0568
6 · The paper itself

Abstract

purposeTotal knee arthroplasty (TKA) has significant perioperative blood loss and a high transfusion rate. Tranexamic acid (TXA) has widely recognized hemostatic efficacy in TKA. Hemocoagulase Agkistrodon (HCA) enhances coagulation by hydrolyzing fibrinogen into fibrin, complements the hemostatic effect of TXA. Our aim was to investigate the hemostatic potential of sequential administration of HCA and TXA in TKA.

methodsPatients who underwent cemented total knee arthroplasty at our hospital were randomized to receive the sequential administration of HCA and TXA (n = 29) or TXA-only (n = 30. All patients received mechanical and chemical thromboprophylaxis protocol. The primary outcome was perioperative blood loss, while secondary outcomes were postoperative coagulation function and arterio-venous thrombosis, transfusion, and complications.

resultsTotal blood loss was not different between sequential administration of HCA and TXA group (1,025.3 ± 305.3 mL) and TXA-only group (892.4 ± 306.4 mL, P = 0.079). Intermuscular vein thrombosis was reported in one case in the sequential administration group and three cases in the TXA-only group. No deep vein thrombosis was reported in any of the patients. The two groups had no perioperative transfusion.

conclusionThe sequential administration of HCA and TXA does not demonstrate superior efficacy in reducing blood loss compared to TXA-only. However, the HCA and TXA group has a lower incidence of intermuscular thrombosis and may demonstrate superiority in postoperative thromboprophylaxis.

Indexed as

AgkistrodonArthroplasty, Replacement, KneeBlood Loss, SurgicalTranexamic AcidAgedAged, 80 and overAntifibrinolytic AgentsFemaleHumansMaleMiddle AgedTreatment OutcomeAntifibrinolytic AgentsTranexamic AcidBlood lossHemocoagulase AgkistrodonTotal knee arthroplastyTranexamic acid

Identifiers

PMID40355919
PMCPMC12070700

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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.