The Therapeutic Effects Of Tranexamic Acid Combined With "Cocktail" On Unilateral Total Knee Arthroplasty

ObejectiveTo evaluate the therapeutic effects of tranexamic acid combined with "cocktail"on unilateral total knee arthroplasty from the following three aspects1 To observe the analgesic effect, we give a comparation of VAS score and HSS score between the TKA cases which used tranexamic acid combined with"cocktail" and the TKA cases not used this technique.2 For the cases used tranexamic acid combined with "cocktail" on unilateral total knee arthroplasty, we observe the difference of reduction of Hb 3 d after operation and total blood loss 3 d after operation to evaluate the therapeutic effect of blood loss.3 To analysis the complication of tranexamic acid combined with "cocktail"technique of TKA surgery, we observe the swelling degree of legs, the incidence of venae cava inferior thrombosis and the infection rate.MethodsClinical data about 120 patients with terminal osteoarthritis of the knee have unilateral total knee arthroplasty in Chinese PLA General Hospital from June 1 in 2014 to June 1 in 2016 were collected.Patients were divided into two groups randomly: experimental group (n=60 knees) received intraoperative intra-articular of tranexamic acid combined with "cocktail" on unilateral total knee arthroplasty and control group (n=60 knees) received traditional unilateral total knee arthroplasty.The differences in baseline data between two groups were insignificant (P> 0.05) .The differences of perioperative data between two groups were analyzed, including operating time, intraoperative blood loss,tourniquet time, reduction of Hb 3 d after operation, total blood loss 3 d after operation, thigh perimeter change rate, crus perimeter change rate.VAS score were tested 1, 2, 3, 4, 5, 14 d after operation.HSS score were tested 1, 3 months after surgery.ResultsThe differences of the operating time, intraoperative blood loss, tourniquet time,thigh perimeter change rate and crus perimeter change rate between two groups were statistically insignificant (P>0.05) .In the observation group, reduction of Hb 3 d after operation and total blood loss 3 d after operation were (23.5 ± 7.2) g/L and (949.3 ±154.9) ml,less than (26.2±6.9) g/L and (1078.1 ±201.8) ml of the control group, the difference were statistically significant (P< 0.05) .In the observation group,the VAS scores 1, 2, 3d after surgery were 6.3 ±1.7, 6.3 ±1.6 and 5.9 ±1.5, less than 6.9 ±1.2, 6.8 ± 0.9 and 6.4 ±1.0 of the control group,the difference were statistically significant (P< 0.05) .The differences of VAS scores 4,5, 14d after surgery between two groups were statistically insignificant (P>0.05)The differences of HSS scores 1, 3months after surgery between two groups were statistically insignificant (P>0.05).Conclution?Compared to the regular TKA without tranexamic acid and "cocktail",the use of tranexamic acid combined with "cocktail" could alleviate the pain at least 3 days. It is helpful for the early analgesia after TKA.?Compared to the control group, experimental group had lower reduction of Hb 3d after operation and total blood loss 3d after operation, proved the therapeutic effect to blood loss.?The differences of the thigh perimeter change rate and crus perimeter change rate between two groups were statistically insignificant (P>0.05) , we could not concouded that the use of tranexamic acid combined with "cocktail" has effect of detumescence.Meanwhile, there were no cases of the venae cava inferior thrombosis or the infection.Intraoperative intra-articular injection of tranexamic acid combined with "cocktail"on unilateral total knee arthroplasty provides advantages in short-term pain relief and less blood loss in perioperative period.It is helpful for the early recovery of patients with unilateral total knee arthroplasty.