Edward Julia, Al-Shakfa Fidaa, Newman Nicholas, Lavoie Frédéric
CHUM Research Centre, Centre de Recherche du Centre Hospitalier de l'Universite de Montreal, 1000, rue St- Denis, Montréal, Québec, H2X 0C1, Canada.
Arch Orthop Trauma Surg. 2024 Jul;144(7):3017-3024. doi: 10.1007/s00402-024-05411-5. Epub 2024 Jun 28.
High tibial osteotomy (HTO) is a surgery performed to treat the symptoms and prevent the progression of medial osteoarthritis. Post-operative bleeding has led to early returns to hospital following surgery. Intrafocal injection of tranexamic acid (TXA) could reduce this bleeding complication. The objective of the study was to evaluate the effect of TXA during HTO on the incidence of post-operative complications and early returns to hospital.
This retrospective study included 251 cases of HTO performed between May 2012 and October 2021, with the use of TXA introduced in May 2017. The experimental (n = 102) and control (n = 149) groups were compared as to the rate of post-operative early returns. The influence of confounding factors was evaluated, including age, sex, body mass index (BMI), tobacco use, grade of medial femorotibial osteoarthritis (MFTO), magnitude of angular correction (MAC), and surgery duration.
No statistically significant difference was found between the groups with regards to all variables except age. The experimental group was significantly older (54.4 years; σ = 7.5) than the control group (50.4 years; σ = 7.9; p < 0.001). We observed a decrease in emergency department (ED) visits in the experimental group (15.7%) compared to the control (30.2%; p = 0.008) and a decrease in early returns in the experimental group (28.4%) compared to the control (40.5%; p = 0.049). No statistically significant difference in demographic data, MFTO, or MAC was found among patients with and without an early return, in both the experimental and control groups.
The intrafocal injection of TXA during HTO decreases early returns to hospital.
高位胫骨截骨术（HTO）是一种用于治疗症状并预防内侧骨关节炎进展的手术。术后出血导致患者术后早期重返医院。病灶内注射氨甲环酸（TXA）可减少这种出血并发症。本研究的目的是评估HTO手术中TXA对术后并发症发生率和早期重返医院情况的影响。
这项回顾性研究纳入了2012年5月至2021年10月期间进行的251例HTO手术病例，TXA于2017年5月开始使用。比较了试验组（n = 102）和对照组（n = 149）的术后早期重返率。评估了混杂因素的影响，包括年龄、性别、体重指数（BMI）、吸烟情况、股胫内侧骨关节炎（MFTO）分级、角度矫正幅度（MAC）和手术时长。
除年龄外，两组在所有变量上均未发现统计学上的显著差异。试验组（54.4岁；标准差 = 7.5）明显比对照组（50.4岁；标准差 = 7.9；p < 0.001）年龄大。我们观察到试验组的急诊就诊率（15.7%）低于对照组（30.2%；p = 0.008），试验组的早期重返率（28.4%）低于对照组（40.5%；p = 0.049）。试验组和对照组中，有早期重返和无早期重返的患者在人口统计学数据、MFTO或MAC方面均未发现统计学上的显著差异。
HTO手术中病灶内注射TXA可降低早期重返医院的发生率。
