title: Combination of intravenous and topical application of tranexamic acid in primary total knee arthroplasty: a prospective randomized controlled trial.
abstract: This study was aimed to determine the efficacy and safety of combined intravenous (IV) and topical application of tranexamic acid (TXA) in unilateral total knee arthroplasty (TKA) compared with the IV-TXA. One hundred eight-four patients were enrolled. Participants received either 3g of IV-TXA or 1.5g topical TXA combined with 1.5g IV-TXA. The results revealed that compared with the 3g IV-TXA, adding 1.5g topical TXA to 1.5g IV-TXA in unilateral TKA can have the similar effectiveness in reducing transfusion rate and total blood loss without sacrificing safety. The most important is that by adding topical TXA, patients can gain a smaller maximum decline of hemoglobin (Hb), less drainage volume, less postoperative knee pain, less knee swelling, shorter length of hospital stays and higher short-term satisfaction.
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: ZeYu
authors.initials: Z
authors.lastname: Huang
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Jun
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shen
authors.affiliation: Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, People's Republic of China.
authors.forename: FuXing
authors.initials: F
authors.lastname: Pei
mesh_terms: D061605:Administration, Intravenous; D000287:Administration, Topical; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: blood loss; knee swelling; total knee arthroplasty; tranexamic acid; transfusion rate