Guerreiro João Paulo Fernandes, Lima Diogenes Rodrigues, Bordignon Glaucia, Danieli Marcus Vinicius, Queiroz Alexandre Oliveira, Cataneo Daniele Cristina
Hospital de Ortopedia Uniort. e, Londrina, PR, Brazil.
Hospital Evangélico de Londrina, Londrina, PR, Brazil.
Acta Ortop Bras. 2019 Sep-Oct;27(5):248-251. doi: 10.1590/1413-785220192705214417.
To evaluate the efficacy of platelet-rich plasma (PRP) and tranexamic acid (TXA) applied in total knee arthroplasty.
We selected and randomized 84 patients. TXA was applied in 23 patients, PRP in 20, and PRP in combination with TXA in 20. Hemoglobin was measured preoperatively and 24 and 48 hours postoperatively. The function questionnaire, pain scale and gain of knee flexion were monitored until the second postoperative year.
There was a difference (p <0.01) in the decrease in hemoglobin 48 hours after surgery between the TXA group and the control and PRP groups. In terms of pain, the TXA group at 24 and 48 hours after surgery and the PRP group at 48 hours after surgery showed advantages (p <0.01). Knee flexion gain in the first 24 hours postoperatively was better in the TXA group (p <0.05).
TXA was effective in lowering the drop in hemoglobin level, reducing pain and improving movement gain 48 hours after the procedure. PRP was not effective in reducing bleeding or improving knee function after arthroplasty, but provided better control of postoperative pain.
评估富血小板血浆（PRP）和氨甲环酸（TXA）应用于全膝关节置换术的疗效。
我们选取并随机分配了84例患者。23例患者应用TXA，20例应用PRP，20例应用PRP联合TXA。术前以及术后24小时和48小时测量血红蛋白。监测功能问卷、疼痛量表和膝关节屈曲度增加情况直至术后第二年。
TXA组与对照组和PRP组相比，术后48小时血红蛋白下降存在差异（p<0.01）。在疼痛方面，术后24小时和48小时的TXA组以及术后48小时的PRP组显示出优势（p<0.01）。术后前24小时TXA组膝关节屈曲度增加情况更好（p<0.05）。
TXA在降低血红蛋白水平下降、减轻疼痛以及改善术后48小时的活动度增加方面有效。PRP在减少关节置换术后出血或改善膝关节功能方面无效，但能更好地控制术后疼痛。
