Use of Tranexamic Acid at Knee Joint Arthroplasty

Results of comparative study of the efficacy and safety of intraoperative application of tranexam versus autoplasma in patients with planned surgical blood loss and high risk of venous thrombosis development has been presented. One hundred seven patients admitted for total knee replacement were divided into 2 groups. In the main group (55 patients) intraoperative intravenous infusion of 10 mg/kg tranexam were used. In the control group (52 patients) intraoperative hemodilution with autoplasma was performed. Hemostasis indices (APTT, INR, SFMC, D- dimer) and lysis index were studied before surgery and in postoperative period. Ultrasound scanning of lower extremity veins was performed before surgery and in 4—5 days after intervention. The volume of intraoperative blood loss in two groups did not differ. In the postoperative period the drainage blood loss in the main group was more than twice lower as compared to the control group (p=0,037). In postoperative period statistically significant increase in SFMC and D-dimer indices was noted in both groups. However after tranexam application the increase in fibrin lysis products content was reliably less marked than in control group. US investigation of lower extremities showed distal veins thrombosis in 2 patients from control group and no cases of thrombosis in the main group.

venous thrombosis, blood loss, fibrinolysis inhibitors, tranexam, plasma