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Randomized Controlled Trial
. 2017:2017:9105645.
doi: 10.1155/2017/9105645. Epub 2017 Dec 19.

Topical Tranexamic Acid Reduces Blood Loss in Minimally Invasive Total Knee Arthroplasty Receiving Rivaroxaban

Shih-Hsiang Yen  1 , Po-Chun Lin  1 , Bradley Chen  2 , Chung-Chen Huang  3 , Jun-Wen Wang  1
Affiliations
Randomized Controlled Trial

Topical Tranexamic Acid Reduces Blood Loss in Minimally Invasive Total Knee Arthroplasty Receiving Rivaroxaban

Shih-Hsiang Yen et al. Biomed Res Int. 2017.

Abstract

Background: It is unclear whether topical (intra-articular) or intravenous TXA reduces blood loss in minimally invasive TKA patients receiving a direct oral anticoagulant for thromboprophylaxis. This study is to investigate whether TXA given intravenously or intra-articularly is effective in reducing blood loss in minimally invasive TKA patients using rivaroxaban for thromboprophylaxis.

Methods: Ninety-three patients who underwent primary minimally invasive TKA were divided into placebo group (30 patients) that received saline both intravenously and intra-articularly, intravenous (IV) group (31 patients) that received 1 g TXA intravenously, and topical group (32 patients) that received 3 g TXA in 100 ml saline intra-articularly. All patients received oral rivaroxaban of 10 mg daily for 14 days postoperatively.

Results: p < 0.001 and p = 0.041. The mean total blood loss was 1131 mL (567-1845) in placebo, which was higher than that in the IV group (921 mL; range, 465-1495; p = 0.014) and the topical group (795 mL; range, 336-1350; p < 0.001). The total blood loss did not differ between the IV and the topical group (p = 0.179).

Conclusion: This prospective, randomized, controlled trial demonstrated an equal efficacy of TXA in blood conservation when administered intravenously or topically in minimally invasive TKA patients receiving rivaroxaban for thromboprophylaxis.

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Figures

Figure 1
Figure 1
Flow chart of patient selection and analysis throughout the study. IV: intravenous, MIS: minimally invasive surgery, and TKA: total knee arthroplasty.
See this image and copyright information in PMC

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