Klinik Für Orthopädie Und Unfallchirurgie, Martin Luther Hospital, Caspar-Theyß-Straße 27-31, Grunewald, 14193, Berlin, Germany.
Arch Orthop Trauma Surg. 2022 Sep;142(9):2287-2293. doi: 10.1007/s00402-021-04219-x. Epub 2021 Oct 26.
Aim of this study was to evaluate the effect of tranexamic acid (TXA) on the outcome after medial open wedge osteotomy.
A prospective non-randomized comparative study with 52 patients has been performed. In both treatment groups, the same surgical technique for the medial open wedge HTO was used. In group 1 (N: 26) the patients received 1 g TXA i.v. preoperatively, in group 2 (N: 26) no TXA was given. Primary outcome measure was the decrease in hemoglobin concentration. Secondary outcome criteria were postoperative pain, intraarticular effusion (measured by ultrasound), range of motion (ROM) at discharge, peri- and postoperative complications and the KOOS PS (pre- and postoperatively at 1 year follow up).
Hemoglobin decrease was significantly less in the TXA group compared to the non TXA group. Postoperative pain and intraarticular effusion was also significantly lower and ROM at discharge was higher in the TXA group. There was no group difference in peri- and postoperative complications and the pre- and postoperatively KOOS PS.
The results of the present study show the systemic application of 1 g TXA reduces hemoglobin drop and postoperative morbidity (pain, intraarticular effusion, and ROM) after tibial open wedge HTO.
本研究旨在评估氨甲环酸（TXA）对内侧开放楔形截骨术后结果的影响。
进行了一项前瞻性非随机对照研究，共纳入 52 例患者。在两组治疗中，均采用相同的内侧开放楔形 HTO 手术技术。在第 1 组（N=26）中，患者术前静脉给予 1 g TXA；在第 2 组（N=26）中，未给予 TXA。主要观察指标为血红蛋白浓度下降。次要观察指标包括术后疼痛、关节内积液（超声测量）、出院时的关节活动度（ROM）、围术期并发症和 KOOS PS（术前和术后 1 年随访）。
与非 TXA 组相比，TXA 组的血红蛋白下降明显较少。TXA 组的术后疼痛和关节内积液也明显较低，出院时的 ROM 较高。两组在围术期并发症和术前、术后 KOOS PS 方面无差异。
本研究结果表明，胫骨内侧开放楔形截骨术后，系统应用 1 g TXA 可减少血红蛋白下降和术后发病率（疼痛、关节内积液和 ROM）。
