Weighted Versus Uniform Dose of Tranexamic Acid in Patients Undergoing Primary, Elective Knee Arthroplasty: A Prospective Randomized Controlled Trial
Section snippets
Study Design
This study is a prospective, randomized, double-blinded controlled clinical trial to compare the effect of a single uniform 1 g dose of TA to a single weighted 20-mg/kg dose in primary TKA. Consecutive patients that were candidates for TKA in the senior author's clinic were offered enrollment in this study. Exclusion criteria included, age less than 18, age greater than 85, prior history of an open surgical procedure on the operative knee, significant cardiac disease and/or history of a previous
Results
At present 44 patients have been enrolled (enrollment rate = 55%) with 40 successfully completing the study protocol. The average age of patients in the standard group was 67.6 (range, 52–82 years), 66.5 (range, 50–76 years) in the weighted dose group, and 62.4 years (range, 44–86) in the control group. There were 6 males and 14 females enrolled in both treatment groups with an equal split of 20 patients being randomly assigned to the weighted dose and uniform dose. There were no statistically
Discussion
The addition of TA to the regimen of blood management and conservation in TKA has significantly reduced the need for allogenic transfusions with a respectable and well documented safety profile 1., 2., 4., 5.. The current study supports this literature with significant reductions in allogenic blood transfusions in primary TKA patients when using either a weighted or standard (1000 mg) dose of TA compared to control patients following the same protocols without the administration of TA. The
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The Safety of Tranexamic Acid in Total Joint Arthroplasty: A Direct Meta-Analysis
2018, Journal of ArthroplastyCitation Excerpt :After completion of the quality assessment, only randomized clinical trials representing the highest quality of evidence remained, leaving 79 publications with 7164 patients to be included for our meta-analysis of VTE or ATE. After the quality assessment, 78 randomized clinical trials were available for the meta-analysis of VTE encompassing 7044 patients (Table 1) [15–92]. Published randomized clinical trials included comparisons between placebo and IV, topical, oral, combined IV/topical, or combined IV/oral TXA.
Intra-articular Application is More Effective Than Intravenous Application of Tranexamic Acid in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial
2017, Journal of ArthroplastyCitation Excerpt :The range of these weighted doses varied from 10-20 mg/kg, and repetition and timing of doses were varied across studies as well [14]. One randomized controlled study suggested that a single 1-g dose before tourniquet release can be used with the same efficacy as a weighted 20 mg/kg IV dose [10]. Prior randomized controlled study showed a single 20 mg/kg IV dose TXA not only saved more blood but also cost less compared with reinfusion system [8].
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The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2014.01.038.