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

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.