A study of the efficacy of different routes of administration of tranexamic acid in elderly patients undergoing knee arthroplasty
ZHANG Ying-tao
WANG Hong-jian
YANG Yan
ZHU Peng-cheng
HE Wen-sheng
Abstract：Objective To compare the efficacy of different routes of tranexamic acid(TXA)administration in elderly total knee arthroplasty(TKA)patients.Methods 114 TKA patients admitted to our hospital between February 2021 and February 2024 were selected.The patients were divided into 3 groups according to the random number table method with 38 cases in each group,including intravenous(IV)drip TXA 1 g group(IV group),intra-articular(IA)injection TXA 2 g group(IA group)and IV TXA 1 g combined with IA TXA 1 g group(IV+IA group).Perioperative indicators,joint swelling,visual analogue scale(VAS)of pain and Knee Society score(KSS)were compared among the three groups.Results Intraoperative blood loss,occult blood loss,drainage fluid volume,transfusion frequency and hospital day were lower for patients in the IV+IA group than those in the IV and IA group(P<0.05);the complication rate was lower in the IV+IA group than in the IV and IA groups(13.2%vs.39.5%vs.36.8%,P=0.013);the prothrombin time(PT),activated partial thromboplastin time(APTT),international normalised ratio(INR),D-dimer(D-D)and C-reactive protein(C-RP)of the IV+IA group were lower than those of patients in IV group and IA group,while the fibrinogen(Fib)was higher than those of patients in group IV and IA one and seven days postoperatively(P<0.05).Knee swelling was lower in patients in the IV+IA group than in patients in the IV and IA groups at 3 days,14 days,1 month,and 3 months after surgery(P<0.05).VAS was lower in patients in the IV+IA group than in patients in the IV and IA groups at 3 days,14 days,and 1 month after surgery(P<0.05).KSS was higher in patients in the IV+IA group than in patients in the IV and IA groups at 3 days,14 days,1 month,and 3 months after surgery(P<0.05).Conclusions Compared with IV and IA group,IV combined with IA TXA can significantly reduce intraoperative and postoperative bleeding,blood transfusion,pain and complications in patients with TKA,accelerating the recovery of knee function with better efficacy.
Keywords：ArthroplastyreplacementkneeTranexamic acidComparative effectiveness research
Publication Date：2024-09-19
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 737-742 )