Tropical Journal of Pharmaceutical Research

Original Research Article | OPEN ACCESS

Effect of tranexamic acid and total knee arthroplasty on perioperative coagulation indices and blood loss in patients with knee osteoarthritis

Xiaoyu Liang¹, Zhongfu Zhao¹, Dexun Zou¹, Qi Zhang²

¹Medical Examination Section, The Second Affiliated Hospital of Qiqihar Medical College, No. 64, Zhonghua West Road, Jianhua District, China; ²Department of Orthopedic, The First Hospital of Qiqihar and Affiliated Qiqihar Hospital, Southern Medical University, No. 700 Bukui South Street, Longsha District, Qiqihar City, Heilongjiang Province, China.

For correspondence:- Qi Zhang Email: zhangqiqi803@163.com

Accepted: 22 February 2023 Published: 31 March 2023

Citation: Liang X, Zhao Z, Zou D, Zhang Q. Effect of tranexamic acid and total knee arthroplasty on perioperative coagulation indices and blood loss in patients with knee osteoarthritis. Trop J Pharm Res 2023; 22(3):625-631 doi: 10.4314/tjpr.v22i3.21

© 2023 The authors.
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Abstract

Purpose: To study the effect of the combination of tranexamic acid and total knee arthroplasty (TKA) on perioperative coagulation indices and blood loss in patients with knee osteoarthritis (KOA).

Methods: A total of 78 KOA patients who received TKA in Second Affiliated Hospital of Qiqihar Medical College from July 2020 to July 2022 were recruited and randomized to study and control groups in a ratio of 1:1 (n = 39). Patients in control group received 0.9 % sodium chloride, while those in study group were treated with 0.9 % sodium chloride plus tranexamic acid after TKA. Parameters evaluated include intraoperative bleeding, drainage volume, occult blood loss, and total blood loss.

Results: The two groups of patients had similar intraoperative blood loss (p > 0.05). Tranexamic acid significantly reduced postoperative drainage volume, occult blood loss, and total blood loss in TKA patients (p < 0.05). Before and after treatment, no intergroup differences were seen in prothrombin time, activated partial thromboplastin time, fibrinogen, and D-dimer (D-D) levels (p > 0.05). The D-D levels of all patients showed a significant increase after TKA (p < 0.05). Patients with tranexamic acid exhibited significantly higher serum hemoglobin (Hb) concentrations and lower serum white blood cell count (WBC) than those without tranexamic acid during TKA (p < 0.05).

Conclusion: Tranexamic acid plus TKA effectively reduces the intraoperative blood loss of KOA patients, restores knee function, improves serological condition, and lowers the incidence of postoperative complications and transfusion risk. Multicenter large-scale trials are, however, required prior to application in clinical practice.

Keywords: Tranexamic acid, Total knee arthroplasty, Knee osteoarthritis, Perioperative period, Coagulation index, Blood loss