Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: a multicenter, randomized, controlled trial.
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- dc.contributor.author Aguilera, Xavierca
- dc.contributor.author Martínez Zapata, María Joséca
- dc.contributor.author Hinarejos Gómez, Pedro Angelca
- dc.contributor.author Jordà, Mireiaca
- dc.contributor.author Leal Blanquet, Joanca
- dc.contributor.author González, J. C.ca
- dc.contributor.author Monllau García, Juan Carlosca
- dc.contributor.author Celaya, F.ca
- dc.contributor.author Rodríguez-Arias, A.ca
- dc.contributor.author Fernández, J. A.ca
- dc.contributor.author Pelfort López, Javierca
- dc.contributor.author Puig Verdié, Luísca
- dc.date.accessioned 2015-06-30T10:05:37Z
- dc.date.available 2016-07-31T02:00:04Z
- dc.date.issued 2015
- dc.description.abstract NTRODUCTION: Tranexamic acid (TXA) is becoming widely used in orthopedic surgery to reduce blood loss and transfusion requirements, but consensus is lacking regarding the optimal route and dose of administration. The aim of this study was to compare the efficacy and safety of topical and intravenous routes of TXA with routine hemostasis in patients undergoing primary total knee arthroplasty (TKA). MATERIALS AND METHODS: We performed a randomized, multicenter, parallel, open-label clinical trial in adult patients undergoing primary TKA. Patients were divided into three groups of 50 patients each: Group 1 received 1 g topical TXA, Group 2 received 2 g intravenous TXA, and Group 3 (control group) had routine hemostasis. The primary outcome was total blood loss. Secondary outcomes were hidden blood loss, blood collected in drains, transfusion rate, number of blood units transfused, adverse events, and mortality. RESULTS: One hundred and fifty patients were included. Total blood loss was 1021.57 (481.09) mL in Group 1, 817.54 (324.82) mL in Group 2 and 1415.72 (595.11) mL in Group 3 (control group). Differences in total blood loss between the TXA groups and the control group were clinically and statistically significant (p < 0.001). In an exploratory analysis differences between the two TXA groups were not statistically significant (p = 0.073) Seventeen patients were transfused. Transfusion requirements were significantly higher in Group 3 (p = 0.005). No significant differences were found between groups regarding adverse events. CONCLUSION:/nWe found that 1 g of topical TXA and 2 g of intravenous TXA were both safe strategies and more effective than routine hemostasis to reduce blood loss and transfusion requirements after primary TKA.ca
- dc.description.sponsorship This project was funded principally by a grant from the Spanish Ministry of Health and Social Policy to promote independent clinical research 2010 (EC10-73).
- dc.format.mimetype application/pdfca
- dc.identifier.citation Aguilera X, Martínez-Zapata MJ, Hinarejos P, Jordán M, Leal J, González JC. et al. Arch Orthop Trauma Surg. 2015 Jul;135(7):1017-25. doi: 10.1007/s00402-015-2232-8.ca
- dc.identifier.doi http://dx.doi.org/10.1007/s00402-015-2232-8
- dc.identifier.issn 0936-8051
- dc.identifier.uri http://hdl.handle.net/10230/24573
- dc.language.iso engca
- dc.publisher Springer Verlagca
- dc.relation.ispartof Archives of Orthopaedic and Trauma Surgery. 2015 Jul;135(7):1017-25
- dc.rights c) Springer (The original publication is avalaible al www.springerlink.com)ca
- dc.rights.accessRights info:eu-repo/semantics/openAccess
- dc.subject.other Artroplàstiaca
- dc.title Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: a multicenter, randomized, controlled trial.ca
- dc.type info:eu-repo/semantics/articleca
- dc.type.version info:eu-repo/semantics/acceptedVersionca