YU Zhenyang, CAI Xu, GU Wang, FANG Min. Therapeutic effects of intra-articular tranexamic acid combined with "cocktail" therapy on unilateral total knee arthroplasty[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2017, 38(2): 115-119. DOI: 10.3969/j.issn.2095-5227.2017.02.006
Citation: YU Zhenyang, CAI Xu, GU Wang, FANG Min. Therapeutic effects of intra-articular tranexamic acid combined with "cocktail" therapy on unilateral total knee arthroplasty[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2017, 38(2): 115-119. DOI: 10.3969/j.issn.2095-5227.2017.02.006

Therapeutic effects of intra-articular tranexamic acid combined with "cocktail" therapy on unilateral total knee arthroplasty

More Information
  • Received Date: October 25, 2016
  • Available Online: November 25, 2023
  • Objective To observe the clinical therapeutic effects of intraoperative intra-articular tranexamic acid combined with "cocktail" therapy on unilateral total knee arthroplasty. Methods Clinical data about 120 patients with terminal osteoarthritis of the knee underwent unilateral total knee arthroplasty in Chinese PLA General Hospital from June 1 in 2014 to June 1 in 2016 were collected. Patients were divided into two groups randomly:experimental group (n=60 knees) received intraoperative intra-articular tranexamic acid combined with "cocktail" therapy in unilateral total knee arthroplasty and control group (n=60 knees) received traditional unilateral total knee arthroplasty. The differences in baseline data between two groups were insignifcant (P> 0.05). The differences of perioperative data between two groups were analyzed, including operating time, intraoperative blood loss, tourniquet time, reduction of Hb at 3 d after operation, total blood loss at 3 d after operation, thigh perimeter change rate, crus perimeter change rate. VAS scores were tested at 1, 2, 3, 5, 14 d after operation. HSS scores were tested at 1, 3 months after surgery. Results The differences in operating time, intraoperative blood loss, tourniquet time, thigh perimeter change rate and crus perimeter change rate between two groups were statistically insignifcant (P> 0.05). In the observation group, reduction of Hb and total blood loss at 3 d after operation were (23.5±7.2) g/L and (949.3±154.9) ml, less than (26.2±6.9) g/L and (1078.1±201.8) ml of the control group, the differences were statistically signifcant (P< 0.05). In the observation group, the VAS scores at 1, 2, 3 d after surgery were 6.3±1.7, 6.3±1.6 and 5.9±1.5, less than 6.9±1.2, 6.8±0.9 and 6.4±1.0 of the control group, the differences were statistically signifcant (P< 0.05). The differences of VAS scores at 4, 5, 14 d after surgery between two groups were statistically insignifcant (P> 0.05). The differences of HSS scores at 1, 3 months after surgery between two groups were statistically insignifcant (P> 0.05). Conclusion Intraoperative intra-articular injection of tranexamic acid combined with "cocktail" therapy on unilateral total knee arthroplasty provides advantages in short-term pain relief and less blood loss in perioperative period. It is helpful for the early recovery of patients with unilateral total knee arthroplasty.
  • [1]
    Uesugi K, Kitano N, Kikuchi T, et al. Comparison of peripheral nerve block with periarticular injection analgesia after total knee arthroplasty: A randomized, controlled study[J]. Knee, 2014, 21(4): 848-852. 2 Georgiadis AG, Muh SJ, Silverton CD, et al. A prospective doubleblind placebo controlled trial of topical tranexamic acid in total knee arthroplasty[J]. J Arthroplasty, 2013, 28(8 Suppl): 78-82.
    [3]
    Shemshaki H, Nourian SM, Nourian N, et al. One step closer to sparing total blood loss and transfusion rate in total knee arthroplasty:a meta-analysis of different methods of tranexamic acid administration[J]. Arch Orthop Trauma Surg, 2015, 135(4): 573-588. 4 Puolakka PA, Rorarius MG, Roviola M, et al. Persistent pain following knee arthroplasty[J]. Eur J Anaesthesiol, 2010, 27(5):455-460.
    [5]
    Bourne RB, Chesworth BM, Davis AM, et al. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?[J]. Clin Orthop Relat Res, 2010, 468(1): 57-63. 6 Nakagawa S, Arai Y, Inoue H, et al. Comparative Effects of Periarticular Multimodal Drug Injection and Single-Shot Femoral Nerve Block on Pain Following Total Knee Arthroplasty and Factors Influencing Their Effectiveness[J]. Knee Surg Relat Res, 2016,28(3): 233-238.
    [7]
    郭达,曹学伟,刘军,等.全膝关节置换术后关节局部镇痛的临床研究[J].实用医学杂志,2013,29(20):3339-3341.

    8 Panteli M, Papakostidis C, Dahabreh Z, et al. Topical tranexamic acid in total knee replacement: a systematic review and metaanalysis[J]. Knee, 2013, 20(5): 300-309.
    [9]
    Wong J, Abrishami A, El Beheiry H, et al. Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial[J]. J Bone Joint Surg Am, 2010, 92(15): 2503-2513. 10 Alshryda S, Mason J, Vaghela M, et al. Topical (intra-articular)tranexamic acid reduces blood loss and transfusion rates following total knee replacement: a randomized controlled trial (TRANX-K)[J]. J Bone Joint Surg Am, 2013, 95(21): 1961-1968.
    [11]
    宝音,张红英,段丽军,等.氨甲环酸关节内灌注对全膝关节置换术后失血量的影响[J].解放军医学院学报,2016,37(6):582-585. 12 魏国,梁杰,李玉鹏,等.氨甲环酸联合肾上腺素减少单侧全膝关节置换术后出血的有效性及安全性研究[J].中国全科医学,2016,19(3):327-331.
    [13]
    龚科,张琦,董纪元.双侧全膝关节置换术后输血的危险因素分析[J].解放军医学院学报,2016,37(1):43-46.

    14 Gao F, Sun W, Guo W, et al. Topical Administration of Tranexamic Acid Plus Diluted-Epinephrine in Primary Total Knee Arthroplasty:A Randomized Double-Blinded Controlled Trial[J]. J Arthroplasty,2015, 30(8): 1354-1358.
    [15]
    钱文伟,翁习生,费琦,等.全膝关节置换术中关节周围镇痛的应用研究[J].中华医学杂志,2010,90(37):2593-2596.

    16 Teng Y, Jiang J, Chen S, et al. Periarticular multimodal drug injection in total knee arthroplasty[J]. Knee Surg Sports Traumatol Arthrosc, 2014, 22(8): 1949-1957.
    [17]
    Fu PL, Xiao J, Zhu YL, et al. Efficacy of a multimodal analgesia protocol in total knee arthroplasty: a randomized, controlled trial[J]. J Int Med Res, 2010, 38(4): 1404-1412.
  • Related Articles

    [1]HUANG Jianxiang, CHAI Jiake, WEI Bin, ZHENG Jinguang, QU Yirui, HU Fangchao, XUN Haoyi, SU Xiaowei, CHI Yunfei. Effect of restrictive resuscitation on burn-hemorrhagic shock combined injury: a study of porcine model[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL. DOI: 10.12435/j.issn.2095-5227.2023.054
    [2]CHENG Zhuqiang, DING Zhi, JIN Yi. Status quo and future development of battlefield analgesia[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2018, 39(4): 349-352. DOI: 10.3969/j.issn.2095-5227.2018.04.019
    [3]WEN Tao, ZHENG Shihao, DONG Jiyuan. Effects of multimodal analgesia in pain management after unilateral total knee arthroplasty[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2017, 38(7): 602-605. DOI: 10.3969/j.issn.2095-5227.2017.07.003
    [4]ZHENG Shihao, DONG Jiyuan, CHAI Wei, WEN Tao, LI Xiang. In fluencing factors of intraoperative blood loss in total hip arthroplasty[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2017, 38(5): 484-486,489. DOI: 10.3969/j.issn.2095-5227.2017.05.027
    [5]LI Chengfei, WANG Yongchun, SHI Fei, GAO Yuan, SUN Xiqing. Advances in the effects of weightlessness on blood vessels and vascular endothelial cells[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2017, 38(1): 64-67. DOI: 10.3969/j.issn.2095-5227.2017.01.017
    [6]BAO Yin, ZHANG Hongying, DUAN Lijun, GE Maolin, BAI Jie, LI Dawen. Intra-articular application of tranexamic acid to reduce blood loss after total knee arthroplasty[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2016, 37(6): 582-585. DOI: 10.3969/j.issn.2095-5227.2016.06.016
    [7]ZHANG Yabin, LI Peng, WANG Yiguo, XU Jiao, MAO Kezheng, HAN Zhenchuan, XIONG Sen, MAO Keya. Comparison of blood loss of twodifferent laminectomydecompression in treatment of patients with lumbardegenerativediscdisease[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2016, 37(4): 328-331. DOI: 10.3969/j.issn.2095-5227.2016.04.008
    [8]LI Jia, ZHANG Wei, ZHANG Li-hai, TANG Pei-fu. Advances in anemia and blood transfusion during perioperative hip fracture[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2014, 35(6): 645-647. DOI: 10.3969/j.issn.2095-5227.2014.06.036
    [9]LI Guan-hua, SUI Bo, FENG Ze-guo, WANG Wei, MA Tao. Effect of slow amnesia analgesia induction on endotracheal intubation-induced QTc interval in elderly patients with coronary heart disease[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2012, 33(10): 1064-1066. DOI: 10.3969/j.issn.1005-1139.2012.10.027
    [10]LIANG Zhi-ru, HE Kun-lun, XU Li-ning. Factors influencing survival of patients with intrahepatic cholangiocarcinoma after resection:A multiple factor analysis[J]. ACADEMIC JOURNAL OF CHINESE PLA MEDICAL SCHOOL, 2012, 33(5): 463-465.

Catalog

    Article Metrics

    Article views (38) PDF downloads (4) Cited by()
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return