Less blood loss under concomitant administration of tranexamic acid and indirect factor Xa inhibitor following total knee arthroplasty: a prospective randomized controlled trial

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2013-11, Vol.21 (11), p.2611-2617
• Main Authors: Lee, Sang Hak, Cho, Kye-Youl, Khurana, Sumit, Kim, Kang-Il
• Format: Article
• Language: English
• Subjects: Aged; Anticoagulants; Anticoagulants - therapeutic use; Antifibrinolytic Agents - therapeutic use; Arthritis; Arthroplasty, Replacement, Knee - adverse effects; Blood; Blood Loss, Surgical - prevention & control; Blood transfusions; Bone surgery; Clinical trials; Disease prevention; Drug dosages; Factor Xa Inhibitors; Female; Hemoglobin; Humans; Joint replacement surgery; Knee; Male; Medicine; Medicine & Public Health; Middle Aged; Orthopedics; Osteoarthritis; Osteoarthritis, Knee - surgery; Patients; Polysaccharides - therapeutic use; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - prevention & control; Prospective Studies; Pulmonary embolisms; Thromboembolism; Thrombosis; Tranexamic Acid - therapeutic use; Ultrasonic imaging; Veins & arteries; Venous Thromboembolism - etiology; Venous Thromboembolism - prevention & control
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-012-2213-1

Purpose The objective of this prospective randomized controlled trial was to assess the efficacy and safety of simultaneous application of tranexamic acid and indirect factor Xa inhibitor following total knee arthroplasty (TKA). Methods Seventy-two primary osteoarthritis patients undergoing unilateral TKA using fondaparinux as a basic thromboprophylaxis were randomized to receive either placebo (36 patients) or tranexamic acid (36 patients). Prophylaxis against venous thromboembolism in all patients was administered with subcutaneous doses of 2.5 mg fondaparinux for 5 days post-operatively. Post-operative retransfusion volume, allogenic transfusion volumes and drain amount were recorded for each patient. Level of haemoglobin, prothrombin time, activated partial thromboplastin time and D-dimer were also assessed. Doppler ultrasonography was performed preoperatively and 7 days after surgery. Results The rate of transfusion was lower in the tranexamic acid group than in the placebo group ( p  = 0.007). The drained blood volume during the initial 24 h and until drain removal was smaller in the tranexamic acid group than in the placebo group ( p