Τίτλος:
Similar thromboprophylaxis with rivaroxaban and low molecular weight heparin but fewer hemorrhagic complications with combined intra-articular and intravenous tranexamic acid in total knee arthroplasty
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: To evaluate the efficacy of the combined intravenous and intra-articular administration of tranexamic acid (TXA) to control the collateral effects and complications of rivaroxaban (RIV) after total knee arthroplasty (TKA) and to compare thromboprophylaxis schemes with and without TXA, RIV and low molecular weight heparin (LMWH). Materials and methods: We prospectively studied 158 TKA patients from 2014 to 2018. The patients were randomly assigned into three groups. Group A (46 patients) was administered intravenous and intra-articular TXA and RIV postoperatively; group B (58 patients) was administered TXA as in group A and LMWH postoperatively; and group C (54 patients) was administered saline as in group A and RIV postoperatively. We evaluated blood loss, transfusion requirements and hemorrhagic complications. Results: Hct and Hb values significantly decreased in group C compared to groups A and B, without any difference between groups A and B. Suction drain blood volume output was significantly higher in group C compared to group A and B, without any difference between group A and B. Hemorrhagic complications were more common in group C. No patient experienced clinical findings of VTE. Conclusion: Combined intravenous and intra-articular administration of TXA is safe and effective in TKA, with fewer hemorrhagic complications compared to placebo. Thromboprophylaxis with RIV and LMWH is similar. © 2018, Springer-Verlag France SAS, part of Springer Nature.
Συγγραφείς:
Karampinas, P.K.
Megaloikonomos, P.D.
Lampropoulou-Adamidou, K.
Papadelis, E.G.
Mavrogenis, A.F.
Vlamis, J.A.
Pneumaticos, S.G.
Περιοδικό:
EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY
Εκδότης:
Springer-Verlag France
Λέξεις-κλειδιά:
hemoglobin; low molecular weight heparin; placebo; rivaroxaban; sodium chloride; tranexamic acid; anticoagulant agent; low molecular weight heparin; rivaroxaban; tranexamic acid, aged; Article; bleeding; blood volume; blood volume output; cohort analysis; combination chemotherapy; controlled study; drug efficacy; drug safety; erythrocyte transfusion; female; hematocrit; hematoma; hematuria; human; knee disease; knee swelling; major clinical study; male; monotherapy; postoperative period; priority journal; prospective study; side effect; suction; thrombosis prevention; total knee arthroplasty; urinary tract hemorrhage; venous thromboembolism; very elderly; adult; blood transfusion; combination drug therapy; comparative study; intraarticular drug administration; intravenous drug administration; knee replacement; middle aged; operative blood loss; postoperative hemorrhage; procedures; randomized controlled trial; statistics and numerical data; treatment outcome; venous thromboembolism, Adult; Aged; Aged, 80 and over; Anticoagulants; Arthroplasty, Replacement, Knee; Blood Loss, Surgical; Blood Transfusion; Drug Therapy, Combination; Female; Heparin, Low-Molecular-Weight; Humans; Infusions, Intravenous; Injections, Intra-Articular; Male; Middle Aged; Postoperative Hemorrhage; Prospective Studies; Rivaroxaban; Tranexamic Acid; Treatment Outcome; Venous Thromboembolism
DOI:
10.1007/s00590-018-2307-7
