Comparative Efficacy Of Different Use Of Tranexamic Acid In Total Knee Arthroplasty

Objective :To discuss impact of tranexamic acid(tranexamic acid, TXA)in different way on blood loss and lower extremity deep vein thrombosis in first unilateral total knee arthroplasty(total knee arthroplasty, TKA).Methods : Select the first unilateral TKA surgery patients from June 2013 to May 2014 in our hospital orthopaedic as the research object.There were 102 patients eligible(the former middle line of total knee arthroplasty, the first TKA, and follow-up of patients successfully),included in this study, who were divided into group A(intravenous use, at the same time articular cavity injection tranexamic acid) and group B(articular cavity injection tranexamic acid) and group C(no intravenous use,at the same time articular cavity also no injection tranexamic acid), each group included 34 cases. 11 patients were get rid of this experiment in the process of follow-up, so finally in this experiment there were 31 cases(34.06%) in group A; 28 cases(30.76%) in group B and 32 cases(35.16%)in group C. Each group had no statistical significance(P>0.05) in age, sex, body mass index(bmi), preoperative hemoglobin,preoperative red blood cells, preoperative D-dimer(D-dimer, DD), and preoperative KSS score knee joint mobility parameters such as comparison, operation time, incision length difference.We compared visible comparative,temperature, the total blood loss, postoperative blood loss and hidden blood loss, D- dimer, such as the degree of pain, knee joint swelling degree and the mobility,postoperative knee KSS, Lysholm march, June, HSS score and observed whether patients with the clinical manifestations of lower extremity deep vein thrombosis, If necessary, to do the double lower limb vascular ultrasound. Comparison between groups using single factor analysis of variance.Results:Group A,total blood loss(450.16±91.74) ml, visible blood loss(274.42±81.79) ml, hidden blood loss(177±87.51)ml.Group B,total blood loss(595.21±125.71)ml, visible blood loss(308.72 ± 82.70) ml and hidden blood loss(431.72 ± 181.19)ml.Respectively group C:(818.72 ± 231.08,)ml,(379.47 ± 97.68)ml,(431.72 ±181.19)ml,each group was different statistically significant(P<0.05);total blood loss,visible blood loss and hidden blood loss compared with statistical significance(P<0.05)between group A and group B. Postoperative body temperature change had no statistical significance(P>0.05) between three groups of patients; No patient was found lower extremity deep vein thrombosis. Postoperative function of the knee joint KSS score, HSS score and march Lysholm score were statistically significant(P<0.05), score in group A and group B were higher than group C, but is no statistical significance between group A and group B(P>0.05), and follow-up after six months, three groups of knee joint function of activity and KSS score had no statistical significance(P>0.05).Conclusions:1.In the first unilateral total knee arthroplasty, intravenous use and articular cavity the blood loss of tranexamic acid is markedly lower than the articular cavity injection of tranexamic acid, articular cavity injection of blood loss tranexamic acid is less than those of unused tranexamic acid group.2. There is no statistical significance in temperature change of three groups. Intravenous use and articular cavity, local application group are significantly less than patients who didn't use tranexamic acid group, but no significant change between joint and local application, at the same time no increase the risk of formation of lower extremity deep vein thrombosis.3. The patients who used tranexamic acid, postoperative function of knee joint KSS score,HSS score and the Lysholm score significantly higher than who didn't use tranexamic acid, long-term effect was not significant.