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KMID : 0361620220570020128
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Journal of the Korean Orthopaedic Association
2022 Volume.57 No. 2 p.128 ~ p.134
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Synergistic Effect of Intraarticular Tranexamic Acid Injection and the Use of Navigation in Total Knee Arthroplasty for Reducing Blood Loss
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Song Suk-Kyoon
Jun Chung-Mu
Choi Seung-Cheol
Choi Won-Kee
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Abstract
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Purpose: This study investigated the synergistic effects of an injection of tranexamic acid and using navigation to reduce the need for blood transfusion and postoperative bleeding after total knee arthroplasty (TKA).
Materials and Methods: Patients were divided into three groups and compared. Group 1 (58 cases) included those who had manual TKA with the injection of tranexamic acid in the joint. Group 2 (30 cases) was comprised of those who had navigated TKA without tranexamic acid. Group 3 (32 cases) consisted of patients who had navigated TKA with tranexamic acid. The frequency of transfusion after the operation was measured. To compare bleeding after surgery, drainage volume during 24 hours after surgery was compared and analyzed.
Results: Group 1 had five cases of transfusion (8.6%), while there were 9 cases in group 2 (30%) and three cases in group 3 (9.4%). The Chi-squared test revealed a significant difference (p=0.016). An average of 343.67±165.20 ml, 452.10±197.91 ml, and 311.00±129.32 ml was drained in the 24 hours after surgery in groups 1, 2, and group 3, respectively. This difference was analyzed using ANOVA test, which showed a significant difference (p=0.003). The need for transfusion in group 2 was 3.71 times higher than that in group 1. The need for transfusion in group 2 was 4.14 times higher than that of group 3.
Conclusion: The combination of navigation use and injection of tranexamic acid has no synergistic effect in reducing the need for blood transfusion and post TKA bleeding. In addition, an injection of tranexamic acid in the joint is more effective in reducing blood transfusions and blood loss after TKA than navigation.
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KEYWORD
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bleeding, tranexamic acid, navigation, transfusion, total knee arthroplasty
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