Guerreiro Joao Paulo Fernandes, Badaro Bruno Scatolon, Balbino Jose Rodolfo Martines, Danieli Marcus Vinicius, Queiroz Alexandre Oliveira, Cataneo Daniele Cristina
UNIORT.E Orthopedic Hospital, Londrina, Parana state, Brazil.
Londrina Evangelic Hospital, Londrina, Parana state, Brazil.
Open Orthop J. 2017 Aug 29;11:1049-1057. doi: 10.2174/1874325001711011049. eCollection 2017.
The use of tranexamic acid (TXA) in total knee arthroplasty (TKA) has shown good results. Bleeding may cause local complications consequently greater pain and reduced function postoperatively. No study has related the use of TXA to these facts.
The aim was to evaluate the effects of TXA haemoglobin, Western Ontario and McMaster Universities Index (WOMAC), pain intensity and flexion gain after TKA.
43 patients were randomized and then underwent TKA. TXA was applied to 22 of these patients before closure of the joint capsule. Haemoglobin measurements (mg/dL) were taken preoperatively and 24 and 48 hours after surgery. The WOMAC questionnaire and pain visual analogue scale (VAS) were applied, and flexion gain was measured up to the second postoperative month. Statistical analysis compared the results to determine whether there were differences between the groups for each of the evaluated times.
There were differences in favour of the drug 48 hours postoperatively for the haemoglobin variable (p = 0.01), in pain evaluation, 24 and 48 hours, postoperatively (p < 0.01) and in flexion gain, 24 hours after surgery (p = 0.03). There were no significant differences between the groups in the haemoglobin evaluation 24 hours postoperatively, in pain assessment 7 days, 21 days and 2 months, postoperatively, in flexion gain 48 hours, 7 days, 21 days and 2 months, postoperatively and in WOMAC after 2 months.
In addition to reducing bleeding, topical TXA improved pain and increased flexion gain in the first hours after TKA.
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氨甲环酸（TXA）在全膝关节置换术（TKA）中的应用已显示出良好效果。出血可能导致局部并发症，进而导致术后疼痛加剧和功能减退。尚无研究将TXA的使用与这些情况联系起来。
旨在评估TXA对TKA术后血红蛋白、西安大略和麦克马斯特大学指数（WOMAC）、疼痛强度及屈膝角度增加的影响。
43例患者随机分组后接受TKA。其中22例患者在关节囊闭合前应用TXA。术前、术后24小时和48小时测量血红蛋白水平（mg/dL）。应用WOMAC问卷和疼痛视觉模拟量表（VAS），并测量术后第二个月内的屈膝角度增加情况。通过统计分析比较结果，以确定每组在各评估时间点是否存在差异。
术后48小时，血红蛋白变量方面药物组更具优势（p = 0.01）；术后24小时和48小时的疼痛评估中（p < 0.01）；术后24小时的屈膝角度增加方面（p = 0.03）。术后24小时的血红蛋白评估、术后7天、21天和2个月的疼痛评估、术后48小时、7天、21天和2个月的屈膝角度增加以及术后2个月的WOMAC评分，两组间均无显著差异。
除减少出血外，局部应用TXA还可改善TKA术后最初几个小时的疼痛并增加屈膝角度。
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