Comparison of the efficacy of different tranexamic acid administration strategies in patient undergoing total knee arthroplasty receiving oral rivaroxaban
LI Yunlong
ZHANG Hao
WANG Yongjun
SUN Yufeng
Abstract：Objective To evaluate the effects of different tranexamic acid(TXA)administration on coagulation function and complications in patients undergoing total knee arthroplasty(TKA)receiving oral rivaroxaban.Methods A prospective study was conducted.A total of 72 patients who underwent TKA at Anyang People's Hospital from June 2023 to December 2024 were enrolled and divided into the control group(local TXA injection)and the experimental group(intravenous drip combined with local TXA injection)via a random number table method,with 36 cases in each group.Both groups received routine oral rivaroxaban postoperatively.Perioperative blood loss,coagulation parameters,and the incidence of complications were compared between the two groups.Results There were no statistically significant differences between the two groups in terms of operative time((106.15±31.05)min vs(102.77±30.96)min),tourniquet time((89.23±5.32)min vs(90.51±5.26)min),and intraoperative blood loss((152.27±20.03)mL vs(147.85±19.62)mL)(t=0.463,1.027,0.946,all P>0.05).The total blood loss and hemoglobin reduction at 24 hours postoperatively in the experimental group((712.62±125.77)mL,(18.73±4.55)g/L)were significantly lower than those in the control group((825.63±157.83)mL,(21.57±3.64)g/L)(t=3.360,2.924,both P<0.05).No significant intergroup differences were observed in the changes of prothrombin time((1.32±0.36)s vs(1.42±0.37)s)and acti-vated partial thromboplastin time((4.73±1.25)s vs(5.03±1.67)s)at 24 hours postoperatively(t=1.162,0.863,both P>0.05).The time effect,intergroup effect,and interaction effect of the Visual Analog Scale pain score were statistically significant(F=349.816,21.535,11.500,all P<0.05).For knee joint range of motion,only the time effect was statistically significant(F=75.516,P<0.05).No pulmonary embolism occurred in either group,and there were no statistically significant differences in transfusion rates(8.33%(3/36)vs 5.56%(2/36))or complication rates(16.67%(6/36)vs 11.11%(4/36))(χ2=0.465,P>0.05).Conclusion In TKA pa-tients receiving oral rivaroxaban,combined intravenous and local administration of TXA effectively reduces total postoperative blood loss and hemoglobin decline,without increasing the risks of coagulation dysfunction,blood transfusion,or complications.
Keywords：tranexamic acidrivaroxabanknee arthroplastycoagulation functioncomplications
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：5( 247-251 )