Clinical Comparative Study About Intra-articular Injection Of Tranexamic Acid With Different Drainage Tube Clamping Time After Total Knee Arthroplasty

Research ObjectiveTopical application of tranexamic acid of the knee joint cavity in reducing blood loss after total knee arthroplasty is clinically recognized.However,few systematic studies have been done about tranexamic acid intra-articular injection combined with the duration of the closure of the drainage tube after TKA.To explore the effects of intra-articular injection of tranexamic acid with different drainage tube clamping time after total knee arthroplasty to postoperative blood loss,blood transfusion and complications,To select the optimal drainage tube clamping time about intra-articular injection of tranexamic acid after total knee arthroplasty.Research MethodsWe randomly selected 152 patients with knee osteoarthritis treated in Department of joint surgery,Affiliated Hospital of Qingdao University who undergoing primary unilateral total knee arthroplasty from January 2015 to March 2016.After admission,preoperative examination and comprehensive evaluation of 152 patients,both are comparable.All patients were injected Tranexamic Acid Injection(50 ml,40 mg/ml)into intra-articular and clamped drainage tube after the suture of the joint,Then release tourniquet after compressing the knee joint by bandages.152 patients were randomly divided into 4 groups according to the duration of the closure of the drainage tube after release tourniquet(clipping 1 h group,clamping 2 h group,clamping 3 h group,clamping 4 h group),each group included 38 patients.The amount of intraoperative blood loss,total blood loss,postoperative visible blood loss and hidden blood loss were calculated.Count the number of blood transfusion,limb subcutaneous ecchymosis,knee swelling and limb muscular venous thrombosis after the operation.Knee Hospital for Special Surgery score was evaluated at 6 months after replacement.Statistical analysis was accomplished by SPSS 21.0 package with an acceptance criteria of P<0.05.Research ResultsOver 15 months,the experimental data were obtained from 152 eligible patients,The 4 groups of data were statistically analyzed: 1.In terms of total blood loss,postoperative visible blood loss and hidden blood loss,clamping 3 h group,clamping 4 h group were significantly lower than that of clipping 1 h group,clamping 2 h group,and clamping 2 h group was significantly lower than that of clipping 1 h group.2.Postoperative limb subcutaneous ecchymosis,knee swelling incidence of clamping 4 h group increased significantly.Compared with the other three groups,the difference was statistically significant.3.There was no significant difference between the 4 groups in postoperative limb intermuscular venous thrombosis and the HSS score at 6 months postoperatively.Research ConclusionClamping drainage tube for 3 h is the best choice about Intra-articular injection of tranexamic acid after total knee arthroplasty.It can not only reduce the postoperative blood loss and blood transfusion,but also reduce the incidence of postoperative complications.Research SignificanceTo do a systematic study about drainage tube clamping time after the total knee arthroplasty(TKA)combined with intra-articular injection of tranexamic acid(TXA).It is helpful for further clinical research in the future.