Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2023; 58(04): e599-e603
DOI: 10.1055/s-0043-1771484
Artigo Original
Joelho

Intravenous Use of Tranexamic Acid in Total Knee Arthroplasty with no Tourniquet[*]

Article in several languages: português | English
Filipe Steimbach Cavalli 
1   Médico Residente de Ortopedia e Traumatologia do Hospital Policlínica Pato Branco, Pato Branco, Paraná, Brasil
,
Vinicius Cenci Guarienti 
2   Médico Ortopedista e Traumatologista do Hospital Policlínica Pato Branco, Pato Branco, Paraná, Brasil
,
Fabio Alan Cavali 
3   Médico Ortopedista e Traumatologista do Instituto de Ortopedia e Traumatologia (IOT), Joinville, Santa Catarina, Brasil
,
Osmar Valadão Lopes Junior 
4   Médico Ortopedista e Traumatologista, Instituto de Ortopedia e Traumatologia (IOT), Passo Fundo, Rio Grande do Sul, Brasil
,
Lucas Giachini Antonietti 
1   Médico Residente de Ortopedia e Traumatologia do Hospital Policlínica Pato Branco, Pato Branco, Paraná, Brasil
,
Lucas da Costa Nobre Dalboni 
2   Médico Ortopedista e Traumatologista do Hospital Policlínica Pato Branco, Pato Branco, Paraná, Brasil
› Author Affiliations Financial Support This study received no financial support from public, commercial, or not-for-profit sources.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Objective: To identify blood transfusion requirements and postoperative complications in patients undergoing total knee arthroplasty (TKA) with no tourniquet and intraoperative intravenous administration of tranexamic acid.

Methods: This retrospective observational study analyzed 49 preopeative and postoperative medical records of patients undergoing TKA. A paired t-test compared changes in hemoglobin (HB) and packed cell volume (PCV), and an independent t-test with Welch correction compared HB and PCV changes between genders. A Spearman correlation test determined associations between age and days of postoperative hospitalization with HB and PCV changes. The significance level adopted was p < 0.05.

Results: The patients' mean age was 71.9 ± 6.7 years; most subjects were women (73.5%). The right side (59.2%) was the most affected. Only one participant required a blood transfusion, while three subjects had complications during the postoperative follow-up. No patient had a thromboembolic event. The median length of postoperative hospital stay was 2 days (interquartile range [IQR] = 1.0). There were reductions in HB and PCV levels between the pre-operative and postoperative period, and female patients had a higher HB reduction.

Conclusion: TKA with tranexamic acid and no tourniquet did not cause significant postoperative complications or require blood transfusions.

Keywords

tranexamic acid - arthroplasty, replacement, knee - tourniquet

* Work developed in the Universidade AnhembiMorumbi, Sao Paulo, Brazil..




Publication History

Received: 26 June 2022

Accepted: 27 February 2023

Article published online:
30 August 2023

© 2023. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Leão MG, Santos Santoro E, Lima Avelino R, Inoue Coutinho L, Campos Granjeiro R, Orlando Junior N. Avaliação da qualidade de vida em pacientes submetidos à ATJ em Manaus. Rev Bras Ortop 2014; 49 (02) 194-201
    CrossrefPubMedSearch in Google Scholar
  • 2 Ferreira MC, Oliveira JCP, Zidan FF, Franciozi CES. Artroplastia total de joelho e quadril: a preocupante realidade assistencial do SUS brasileiro. Rev Bras Ortop 2017; 53 (04) 432-440
    CrossrefSearch in Google Scholar
  • 3 Alves Júnior WM, Migon EZ, Zabeu JLA. Dor no joelho após ATJ - uma abordagem sistematizada. Rev Bras Ortop 2010; 45 (05) 384-391
    CrossrefPubMedSearch in Google Scholar
  • 4 Matos LFC, Alves ALQ, Sobreiro AL, Giordano MN, de Albuquerque RSP, Carvalho ACP. Navegação na ATJ: existe vantagem?. Acta Ortop Bras 2011; 19 (04) 184-188
    CrossrefSearch in Google Scholar
  • 5 Gibbs V. Surgical tourniquet use in total knee replacement surgery: a survery of BASK members. Knee 2016; 23 (04) 3-4
    Search in Google Scholar
  • 6 Zekcer A, del Priori R, Tieppo C, Silva RS, Severino NR. Estudo comparativo com uso do ATX tópico e intravenoso em relação à perda sanguínea na ATJ. Rev Bras Ortop 2017; 52 (05) 589-595
    CrossrefPubMedSearch in Google Scholar
  • 7 Ahmed I, Chawla A, Underwood M. et al. Time to reconsider the routine use of tourniquets in total knee arthroplasty surgery. Bone Joint J 2021; 103-B (05) 830-839
    CrossrefPubMedSearch in Google Scholar
  • 8 Guerreiro JPF, Badaro BS, Balbino JRM, Danieli MV, Queiroz AO, Cataneo DC. Application of tranexamic acid in total knee arthroplasty. Open Orthop J 2017; 11: 1049-1057
    CrossrefPubMedSearch in Google Scholar
  • 9 de Barros MFFH, Ribeiro EJC, Dias RG. Variação sanguínea nas ATJ com e sem o uso de garrote. Rev Bras Ortop 2017; 52 (06) 725-730
    CrossrefPubMedSearch in Google Scholar
  • 10 Tan J, Chen H, Liu Q, Chen C, Huang W. A meta-analysis of the effectiveness and safety of using tranexamic acid in primary unilateral total knee arthroplasty. J Surg Res 2013; 184 (02) 880-887
    CrossrefPubMedSearch in Google Scholar
  • 11 Monteiro OM, Perrone RT, Almeida FN, Moura CP, Oliveira SG, Almeida GDB. Comparison of hemostasis with tranexamic acid in total knee arthroplasty. Acta Ortop Bras 2021; 29 (04) 184-188
    CrossrefPubMedSearch in Google Scholar
  • 12 Almeida MDC, Albuquerque RP, Palhares GM, Almeida JPC, Barretto JM, Cavanellas N. Avaliação do uso do ATX em ATJ. Rev Bras Ortop 2018; 53 (06) 761-767
    Search in Google Scholar