Abstract

RAPOSO, João et al. Devemos negar os benefícios do ácido tranexâmico na artroplastia total do joelho? Um novo protocolo. Rev. Port. Ortop. Traum. [online]. 2016, vol.24, n.4, pp.237-246. ISSN 1646-2939.

Total knee arthroplasty is associated with major blood loss, negatively impairing recovery. Blood-sparing techniques have been developed, of which tranexamic acid (TXA) is very cost-effective. Theoretical risk of thrombotic events exists, and many patients have been excluded from therapeutic protocols for safety issues. Retrospective data was collected from patients admitted for primary total knee arthroplasty, allocated to either a systemic (IV) or topical tranexamic acid protocol vs control group. Patients with history of clotting disorders, severe cardiac disease, thromboembolic arterial or venous events and renal impairment were given topical TXA. Outcomes were transfusion of alloegenic blood, hemoglobin drop and blood loss. Statistical analysis - SPSS v20.0, p<0,05. There was a significant difference in hemoglobin drop,  blood loss and in rate and amount of blood transfusions (p<0.001). There were no embolic (PE or DVT) or other systemic or surgical site complications. We found improvement in all the outcomes . To our knowledge, there are no studies describing use of topical tranexamic acid in patients with contraindications for systemic administration, and it may be advantageous to extend the indications for tranexamic acid in total knee replacement, without increased clinical risks.

Keywords : Tranexamic acid; total knee arthroplasty; transfusion.

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