Furqan Ahmad, Hafeez Sohail, Khan Fahim, Orakzai Sajjad H, Nur Aamer N, Khan Muhammad A
Orthopaedics, Shifa International Hospital, Islamabad, PAK.
Orthopedic Surgery, Shifa International Hospital, Islamabad, PAK.
Cureus. 2022 Jan 9;14(1):e21052. doi: 10.7759/cureus.21052. eCollection 2022 Jan.
Background Total knee replacement (TKR) is an artificial joint surgical procedure that replaces the damaged articular surfaces of the knee joint. Despite several studies on the efficacy of intra-articular and intravenous Tranexamic acid (TX) use in reducing blood loss following TKR, the route of TXA administration is still an ongoing topic of debate. Our study aimed to compare total knee replacement efficacy (hemoglobin level, hematocrit level, hospital stay, and complications) of intra-articular and intravenous tranexamic acid administration. Material and Methods A Prospective study was conducted at the Department of Orthopedics, Shifa International Hospital, Islamabad. The study duration was six months (August 2020 to February 2021). A sample size of 60 patients was calculated using the WHO calculator. Patients were selected through non-probability consecutive sampling. Patients were randomly divided into two groups; Group A was given intraarticular TXA, while group B was given intra-venous TXA following total knee replacement. Patients were followed for 48 hours. Data were analyzed using SPSS version 24. An Independent T-test was applied, and a P value≤0.05 was considered significant. Results A total of 60 patients were included in the study. There were 20 (33.3%) male and female 40 (66.7%). The mean age of patients was 64.4±10.8SD. Post-operative hemoglobin level in group A was 11.09±0.39SD, and in group B was 9.93±1.73SD (p=0.03). Postoperatively, the mean HCT level in group A was 30.53±4.26SD and group B 26.88±5.48SD (p=0.01). Conclusion Intra-articular administration of TXA is more effective than intravenous administration in controlling postoperative blood loss following total knee replacement.
全膝关节置换术（TKR）是一种人工关节外科手术，用于替换膝关节受损的关节面。尽管已有多项关于关节内和静脉注射氨甲环酸（TX）减少全膝关节置换术后失血疗效的研究，但氨甲环酸的给药途径仍是一个持续争论的话题。我们的研究旨在比较关节内和静脉注射氨甲环酸的全膝关节置换疗效（血红蛋白水平、血细胞比容水平、住院时间和并发症）。
在伊斯兰堡希法国际医院骨科进行了一项前瞻性研究。研究持续时间为六个月（2020年8月至2021年2月）。使用世界卫生组织计算器计算出60名患者的样本量。通过非概率连续抽样选择患者。患者被随机分为两组；A组在全膝关节置换术后给予关节内氨甲环酸，而B组给予静脉注射氨甲环酸。对患者进行48小时随访。使用SPSS 24版分析数据。应用独立t检验，P值≤0.05被认为具有统计学意义。
共有60名患者纳入研究。其中男性20名（33.3%），女性40名（66.7%）。患者的平均年龄为64.4±10.8标准差。A组术后血红蛋白水平为11.09±？0.39标准差，B组为9.93±1.73标准差（p = 0.03）。术后，A组平均血细胞比容水平为30.53±4.26标准差，B组为26.88±5.48标准差（p = 0.01）。
在全膝关节置换术后控制术后失血方面，关节内注射氨甲环酸比静脉注射更有效。
原文中“Post-operative hemoglobin level in group A was 11.09±0.39SD, and in group B was 9.93±1.73SD (p=0.03).”里A组数据后“±”后数字疑似有误，已按原文翻译。
