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Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration
OBJECTIVES: A significant proportion of surgeons use intra-articular drains after arthroscopic anterior cruciate ligament (ACL) reconstruction. Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction. The purpose of the study was to evaluate the effect of tranexamic aci...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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SAGE Publications
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597633/ http://dx.doi.org/10.1177/2325967114S00136 |
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author | Karaaslan, Fatih Karaoğlu, Sinan Mermerkaya, Musa Uğur |
author_facet | Karaaslan, Fatih Karaoğlu, Sinan Mermerkaya, Musa Uğur |
author_sort | Karaaslan, Fatih |
collection | PubMed |
description | OBJECTIVES: A significant proportion of surgeons use intra-articular drains after arthroscopic anterior cruciate ligament (ACL) reconstruction. Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction. The purpose of the study was to evaluate the effect of tranexamic acid (TXA) administration to minimize pain and stiffness of knee joint by reducing haemarthrosis. METHODS: The study enrolled 123 patients who underwent arthroscopic anterior cruciate ligament reconstruction in a prospective, randomized, double-blind study. The patients who were randomized into the TXA group (71 patients) received both intravenous and intra-articular TXA. The control group (52 patients) did not receive TXA. The anesthetist, surgeon, and observer were blinded to the study group (double-blinded). TXA was administered as a bolus dose of 15 mg/kg 10 minutes before the inflation of the tourniquet on the first side. This was followed by continued intra-articular administration of 3 g at 10 minutes before the deflation of the tourniquet. Intravenous infusion of 10 mg/kg/h was continued for the next 3 hours. Equal volumes of placebo were administered at the same rate and by the same route. We measured volume of drained blood 48 hours postoperatively. RESULTS: The mean (± SD) postoperative volume of blood loss from the drain in the TXA and control groups was 100.6 ± 72mL and 164.3 ± 75mL ml, respectively. The difference between the two groups was significant (p < 0.005). CONCLUSION: This prospective randomized study showed that during arthroscopic anterior cruciate ligament reconstruction, TXA reduced blood loss and helped to reduce haemarthrosis amount and frequency with negligible side effects. With regard to the administration route, combined intravenous–intra-articular administration of TXA significantly reduces blood loss and the need for puncturing associated with arthroscopic anterior cruciate ligament reconstruction without enhancing the risk of deepssssssahrombosis. |
format | Online Article Text |
id | pubmed-4597633 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-45976332015-11-03 Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration Karaaslan, Fatih Karaoğlu, Sinan Mermerkaya, Musa Uğur Orthop J Sports Med Article OBJECTIVES: A significant proportion of surgeons use intra-articular drains after arthroscopic anterior cruciate ligament (ACL) reconstruction. Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction. The purpose of the study was to evaluate the effect of tranexamic acid (TXA) administration to minimize pain and stiffness of knee joint by reducing haemarthrosis. METHODS: The study enrolled 123 patients who underwent arthroscopic anterior cruciate ligament reconstruction in a prospective, randomized, double-blind study. The patients who were randomized into the TXA group (71 patients) received both intravenous and intra-articular TXA. The control group (52 patients) did not receive TXA. The anesthetist, surgeon, and observer were blinded to the study group (double-blinded). TXA was administered as a bolus dose of 15 mg/kg 10 minutes before the inflation of the tourniquet on the first side. This was followed by continued intra-articular administration of 3 g at 10 minutes before the deflation of the tourniquet. Intravenous infusion of 10 mg/kg/h was continued for the next 3 hours. Equal volumes of placebo were administered at the same rate and by the same route. We measured volume of drained blood 48 hours postoperatively. RESULTS: The mean (± SD) postoperative volume of blood loss from the drain in the TXA and control groups was 100.6 ± 72mL and 164.3 ± 75mL ml, respectively. The difference between the two groups was significant (p < 0.005). CONCLUSION: This prospective randomized study showed that during arthroscopic anterior cruciate ligament reconstruction, TXA reduced blood loss and helped to reduce haemarthrosis amount and frequency with negligible side effects. With regard to the administration route, combined intravenous–intra-articular administration of TXA significantly reduces blood loss and the need for puncturing associated with arthroscopic anterior cruciate ligament reconstruction without enhancing the risk of deepssssssahrombosis. SAGE Publications 2014-12-01 /pmc/articles/PMC4597633/ http://dx.doi.org/10.1177/2325967114S00136 Text en © The Author(s) 2014 http://creativecommons.org/licenses/by-nc-nd/3.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For reprints and permission queries, please visit SAGE’s Web site at http://www.sagepub.com/journalsPermissions.nav. |
spellingShingle | Article Karaaslan, Fatih Karaoğlu, Sinan Mermerkaya, Musa Uğur Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration |
title | Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration |
title_full | Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration |
title_fullStr | Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration |
title_full_unstemmed | Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration |
title_short | Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction: Combined Intravenous-Intra-Articular Tranexamic Acid Administration |
title_sort | reducing intra-articular haemarthrosis after arthroscopic anterior cruciate ligament reconstruction: combined intravenous-intra-articular tranexamic acid administration |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4597633/ http://dx.doi.org/10.1177/2325967114S00136 |
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