ArticleArthroplasty (London, England)2026
Tranexamic acid in local infiltration analgesia cocktail for pain and swelling after total knee arthroplasty: a randomized controlled trial.
Article in Arthroplasty (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundPeri-articular local infiltration analgesia (LIA) is a cornerstone technique in multimodal pain management during the peri-operative period of total knee arthroplasty (TKA). Tranexamic acid (TXA), an antifibrinolytic agent, is widely used to reduce post-operative bleeding in TKA. However, no study has systematically evaluated the impact of adding TXA as an adjuvant to the LIA cocktail on post-operative pain and swelling following TKA. The purpose of this study is to investigate the efficacy and convenience of incorporating TXA into the analgesic cocktail for alleviating pain and swelling after TKA.
methodsIn this double-blind, randomized controlled trial, 100 patients undergoing TKA were allocated to either a TXA group or a control group. The TXA group received LIA with an analgesic cocktail consisting of ropivacaine, epinephrine, dexamethasone, and TXA, while the control group received an identical cocktail without TXA. The primary outcome was the pain score at rest at 24 h post-operatively. Secondary outcomes comprised pain scores at other time points, post-operative morphine consumption for rescue analgesia, time to first rescue analgesia, knee swelling rate, decrease in hemoglobin level, range of motion (ROM) of the knee, and incidence of complications.
resultsThe TXA group demonstrated significantly lower VAS pain scores at rest at 24 h post-operatively (3.5 ± 0.6 vs. 4.0 ± 0.7, p = 0.001, and a markedly smaller decline in hemoglobin levels (26.2 ± 7.1 g/L vs. 33.5 ± 7.5 g/L, p < 0.001. Knee swelling rates were also significantly reduced in the TXA group. However, the absolute difference in VAS scores did not exceed the reported minimal clinically important difference (MCID) for pain in TKA (typically 1.0 point). No significant differences were observed between the two groups in post-operative morphine consumption, time to first rescue analgesia, knee ROM, or complication rates.
conclusionThe addition of TXA to a commonly used LIA cocktail led to a statistically significant reduction in early post-operative pain and swelling, along with decreased blood loss, which may offer added convenience by streamlining the workflow. However, the reduction in pain did not meet the MCID, indicating limited clinical relevance in terms of analgesia. Future studies are needed to optimize the analgesic efficacy of TXA-containing cocktails.
trial registrationChinese Clinical Trial Registry, ChiCTR2400086985. Registered 16 July 2024.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.