| Objective: To investigate the postoperative effects of topical tranexamic acid on the hemostatic aspect and the early rehabilitation of total knee arthroplasty.Methods: The study retrospectively select 120 consecutive patients who underwent total knee arthroplasty in the Lou Di centre hospital from 1th December,2014 to 30 th May 2016 hospital.The study group of 51 TKAs who received topical TXA(1 g)before tourniquet deflation was compared with a “control group” of consecutive patients(40 TKAs)in whom No TXA was used..Postoperative data(include the total blood loss,the dominant blood loss,hidden blood loss,blood transfusion rate,postoperative joint swelling degree,KSS score,postoperative pain score)would be performed by SPSS 19.0 to evaluate effect of the topical tranexamic acid on the hidden blood loss and early functional rehabilitation after total knee arthroplasty.Results: Preoperative data(Include General data,weight BMI,Hb,Hct,Thigh circumference,Leg circumference,PT,APTT,KSS)was similar(P > 0.05),so the two groups were comparable.Postoperative hemoglobin was significantly higher in the study than that in the controlgroup on day 1,day 2.(p < 0.05).Blood transfusions were required in7.84% and 70.00% of patients(P <0.05),respectively.In the study group,total blood loss was 756.12±256.14 m,hidden blood loss was582.12ml±191.34ml;total blood loss of the control group was1578.25±453.45 ml,hidden blood loss was 923.56±365.12 ml.There was statistically significant difference in hidden blood loss of tow groups.There was no significant difference in pain score between the study group and the control group on the second and seventh day postoperatively(p>0.05).In the study group,the thigh circumference in 1th and2 nd week postoperatively was 48.45±2.31 cm and 45.67±1.36 cm respectively,and the Leg circumference was 39.36±4.36 cm and36.36±2.36 cm.In the control group,the thigh circumference was50.12±2.36 cm and 47.56±2.26 cm respectively in 1th and 2nd week postoperatively,the leg circumference was 42.58±4.53 cm and39.23±1.21 cm.There was statistically significant difference in the thigh circumference and the leg circumference between the two groups(p<0.05).there were no postoperative infection cerebral hemorrhage and other bleeding disorders in two groups.there were not significant differences between two groups in postoperative thrombosis(p> 0.05),topical tranexamic acid partial articular cavity may not increase the risk of thrombosis.There was no difference in DD between the two groups(p>0.05).Six weeks postoperatively,the FKSS and its 3 categories(abilityto Walk(66.3 vs 57.1),negotiate stairs up and down(17.6 vs 13.5),and need for external support to ambulate(-1.04 vs-3.45))were significantly higher in the study than those in the control group(P < 005),but the KKSS and its 9 individual categories that include pain and ROM were similar in the study and control groups.Four months postoperatively,both FKSS and KKSS were similar in the study and control groups..Conclusion:1?Topical tranexamic acid can effectively reduce the dominant postoperative blood loss hidden blood loss and blood transfusion rate,may play an indirect role on postoperative swelling,but does not increase the risk of venous thrombosis.2? The timeliness of small dose of topical tranexamic acid might not be limited to hospitalization,postoperative bleeding may by means of alleviate edema to affect the early rehabilitation,but 4 month postoperatively,the rehabilitation and restoration of the local tissue effects gradually subsided. |
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