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Archives of Orthopaedic and Trauma Surgery

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01-07-2014 | Knee Arthroplasty

Can tranexamic acid and hydrogen peroxide reduce blood loss in cemented total knee arthroplasty?

Authors: Jerry Yongqiang Chen, Inderjeet Singh Rikhraj, Zhihong Zhou, Darren Keng Jin Tay, Pak Lin Chin, Shi-Lu Chia, Ngai Nung Lo, Seng Jin Yeo

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 7/2014

Abstract

Introduction

The use of tourniquet in total knee arthroplasty (TKA) has resulted in negligible intra-operative blood loss but notable post-operative blood loss, creating the ideal scenario for using topical haemostatic agents intra-operatively. Recently, medical adjuvants including tranexamic acid (TXA) and hydrogen peroxide (H₂O₂) have been introduced. The aim of this study was to evaluate the effectiveness of intra-articular TXA and H₂O₂ in reducing blood loss during TKA.

Materials and methods

Fifty patients, who underwent a primary TKA with 1,500 mg of intra-articular TXA between May 2011 and December 2011, were compared with two matching cohorts of 50 patients each who underwent TKA with 100 ml of 3 % H₂O₂ wash and TKA without any TXA or H₂O₂. All surgeries were performed by two senior surgeons. The total blood loss was calculated by the hemoglobin balance method.

Results

The pre-operative serum hemoglobin levels were 13.1 ± 1.3, 13.1 ± 1.3 and 13.0 ± 1.2 g/dl (p > 0.05); while the drop in serum hemoglobin levels post-operatively was 2.0 ± 0.7, 2.4 ± 0.9 and 2.7 ± 0.8 g/dl for the TXA, H₂O₂ and Control groups, respectively (p < 0.001). The total amount of blood loss was 596 ± 449, 710 ± 279 and 760 ± 228 ml, respectively (p = 0.046). There was no difference in the duration of surgery between the three groups (p > 0.05).

Conclusions

This study showed that intra-articular TXA reduced blood loss during TKA without significantly increasing the duration of surgery. We cannot justify H₂O₂ wash as an alternative to intra-articular TXA to reduce blood loss during TKA.

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Title: Can tranexamic acid and hydrogen peroxide reduce blood loss in cemented total knee arthroplasty?
Authors: Jerry Yongqiang Chen
Inderjeet Singh Rikhraj
Zhihong Zhou
Darren Keng Jin Tay
Pak Lin Chin
Shi-Lu Chia
Ngai Nung Lo
Seng Jin Yeo
Publication date: 01-07-2014
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 7/2014
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-014-1958-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Can tranexamic acid and hydrogen peroxide reduce blood loss in cemented total knee arthroplasty?

Abstract

Introduction

Materials and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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