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  • 标题:Comparison of topical and intravenous administration of tranexamic acid for blood loss control during total joint replacement: Review of literature
  • 本地全文:下载
  • 作者:Georgi P. Georgiev ; Panayot P. Tanchev ; Zlatka Zheleva
  • 期刊名称:Journal of Orthopaedic Translation
  • 印刷版ISSN:2214-031X
  • 出版年度:2018
  • 卷号:13
  • 页码:7-12
  • DOI:10.1016/j.jot.2017.12.006
  • 出版社:Elsevier B.V.
  • 摘要:Purpose

    Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA) without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use.

    Methods

    A literature review containing 63 articles from the PubMed data starting from the first description of tranexamic acid until now was made in trying to present the existing information in a simple and effective way.

    Results

    TXA leads to statistically significant reduction of peri and postoperative bleeding and in that way decreases blood transfusion rates and the infection risk. Topical and intravenous (IV) use of TXA revealed similar results, with no increase of deep venous thrombosis. Therefore, topical TXA could be a reasonable alternative in patients with contraindications for IV application of TXA.

    Conclusions

    Blood loss control with TXA, a synthetic analogue of the amino acid lysine, may be an excellent and safe alternative to allogeneic blood transfusion after total hip arthroplasty and total knee arthroplasty. Further studies are needed to establish the efficacy of combined IV and topical administration of TXA with regard to diminishing blood loss and reducing hospital stay.

    The Translational Potential of this Article

    This review briefly presents the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use with regard to diminishing blood loss and reducing hospital stay for better therapeutic strategies in orthopaedics.

  • 关键词:Arthroplasty ; Review ; Tranexamic acid
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