Sgaglione Jonathan, Havasy Janice, Patel Ronak, Healy Ryan, Yao Vincent, Liu Yulei, Hutchinson Ian, Sama Michael, Piacentini Alexander, Deng Xianghua, Rodeo Scott
Orthopedic Soft Tissue Research Program, Hospital for Special Surgery, New York, NY, USA.
Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
HSS J. 2025 Aug 11:15563316251357603. doi: 10.1177/15563316251357603.
The formation of a stable fibrin clot plays an important role in early tissue repair. Tranexamic acid (TXA), a potent fibrinolysis inhibitor, prevents fibrin clot dissolution.
We sought to test the effect of intra-articular TXA administration on meniscus healing and articular cartilage status in a rabbit model.
Thirty-two rabbits underwent bilateral knee surgery with creation of a 1.5-mm circular defect in the anterior horn of the lateral meniscus and a 3-mm longitudinal tear with repair in the anterior horn of the medial meniscus. Twelve rabbits were used for an initial TXA dose determination study. Twenty rabbits were then injected with 50 mg/mL of TXA in the left knee while the right knee served as a control. Animals were sacrificed at 2-, 4-, and 8-week timepoints. Eight rabbits underwent biomechanical analysis. Semiquantitative histological analysis compared meniscal healing and articular cartilage between TXA-treated and control knees.
Both circular defects of the lateral meniscus and longitudinal tear injuries of the medial meniscus showed no difference in healing across all timepoints. At 2 weeks post-surgery, TXA-treated knees exhibited reduced tibial articular cartilage structure compared to controls. By week 8, control knees had higher proteoglycan content in all femoral articular cartilage zones compared to TXA-treated knees. Biomechanical analysis was inconclusive.
This rabbit study found that TXA administration did not enhance healing following meniscus repair. Moreover, intra-articular TXA appeared to have exerted an adverse effect on articular cartilage, possibly due to the detrimental effects of persistent blood in a joint. Further studies will be critically important to determine the effect of TXA administration at various time points after surgical repair.
稳定的纤维蛋白凝块形成在早期组织修复中起重要作用。氨甲环酸（TXA）是一种有效的纤维蛋白溶解抑制剂，可防止纤维蛋白凝块溶解。
我们试图在兔模型中测试关节内注射TXA对半月板愈合和关节软骨状态的影响。
32只兔子接受双侧膝关节手术，在外侧半月板前角制造一个1.5毫米的圆形缺损，并在内侧半月板前角进行3毫米的纵向撕裂并修复。12只兔子用于初始TXA剂量确定研究。然后20只兔子在左膝注射50mg/mL的TXA，右膝作为对照。在2周、4周和8周时间点处死动物。8只兔子进行生物力学分析。半定量组织学分析比较了TXA治疗组和对照组膝关节的半月板愈合情况和关节软骨情况。
外侧半月板的圆形缺损和内侧半月板的纵向撕裂伤在所有时间点的愈合情况均无差异。术后2周，与对照组相比，TXA治疗组的胫骨关节软骨结构减少。到第8周，与TXA治疗组相比，对照组膝关节在所有股骨关节软骨区域的蛋白聚糖含量更高。生物力学分析尚无定论。
这项兔子研究发现，注射TXA并不能促进半月板修复后的愈合。此外，关节内注射TXA似乎对关节软骨产生了不利影响，可能是由于关节内持续存在血液的有害作用。进一步的研究对于确定手术修复后不同时间点注射TXA的效果至关重要。
