Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Çapa Fatih Istanbul, 34093, Istanbul, Turkey.
Eur J Orthop Surg Traumatol. 2022 Feb;32(2):263-268. doi: 10.1007/s00590-021-02961-x. Epub 2021 Apr 3.
This study aims to determine the efficacy of both tranexamic acid (TXA) and tourniquet on the tibial cement mantle thickness in total knee arthroplasty (TKA).
We retrospectively reviewed the recorded data of patients with primary end-stage knee osteoarthritis who underwent TKA procedure during 2014-2016 at a single institution to evaluate the tibial cement mantle. Patients were categorized in two groups based on the use of tourniquet (groups 1 and 2). In addition, these groups were categorized into two different subgroups based on the use of TXA in groups 1 and 2 (group 1-A, B and group 2-A, B). Four zones at the tibial baseplate on the anteroposterior view and two zones on the lateral view were measured at the 4-6-week postoperative visit.
A total of 28 patients (30 knees) were operated using tourniquet and TXA (group 1-A), 29 (30 knees) using tourniquet without TXA (group 1-B), 24 (28 knees) using TXA without tourniquet (group 2-A), and 38 (42 knees) without using TXA and tourniquet (group 2-B). Although a significant difference was found in the cumulative cement mantle penetration on postoperative X-rays between groups 1 and 2, no significant differences were found between groups A and B in both groups.
This study reports that tourniquet use in TKA increased cement mantle penetration of the tibial component in primary TKA. The main strength of this study was that the TXA use alone exhibited no significant effect on the cement thickness.
本研究旨在确定氨甲环酸（TXA）和止血带对全膝关节置换术（TKA）胫骨水泥覆盖层厚度的疗效。
我们回顾性分析了 2014 年至 2016 年在一家机构接受 TKA 手术的原发性终末期膝骨关节炎患者的记录数据，以评估胫骨水泥覆盖层。根据止血带的使用情况将患者分为两组（第 1 组和第 2 组）。此外，根据第 1 组和第 2 组中 TXA 的使用情况，将这两组分为两个不同的亚组（第 1-A 组、第 1-B 组和第 2-A 组、第 2-B 组）。在术后 4-6 周随访时，在前后位测量胫骨基板的 4 个区和外侧位的 2 个区。
共有 28 例患者（30 膝）使用止血带和 TXA（第 1-A 组）、29 例患者（30 膝）使用止血带而不使用 TXA（第 1-B 组）、24 例患者（28 膝）使用 TXA 而不使用止血带（第 2-A 组）和 38 例患者（42 膝）不使用 TXA 和止血带（第 2-B 组）。虽然第 1 组和第 2 组之间术后 X 射线显示累积水泥覆盖层穿透有显著差异，但两组内 A 组和 B 组之间无显著差异。
本研究报告称，TKA 中使用止血带增加了原发性 TKA 胫骨组件的水泥覆盖层穿透。本研究的主要优势在于单独使用 TXA 对水泥厚度没有显著影响。
