Lee JW, Kim SG, Kim SH, Cho HW, Bae JH. Intra-articular Administration of Tranexamic Acid Has No Effect in Reducing Intra-articular Hemarthrosis and Postoperative Pain After Primary ACL Reconstruction Using a Quadruple Hamstring Graft: A Randomized Controlled Trial.
Orthop J Sports Med 2020;
8:2325967120933135. [PMID:
32743011 PMCID:
PMC7376302 DOI:
10.1177/2325967120933135]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 03/01/2020] [Indexed: 01/17/2023] Open
Abstract
Background:
Insufficient data are available to support the routine use of tranexamic acid
(TXA) in anterior cruciate ligament (ACL) surgeries with respect to
administration method and frequency, exposure duration, dose, and adverse
effects.
Purpose:
To investigate whether intra-articular (IA) administration of TXA could
reduce hemarthrosis and postoperative pain in patients after ACL
reconstruction.
Study Design:
Randomized controlled trial; Level of evidence, 1.
Methods:
A total of 47 patients were included in this study, which was performed
between July 2017 and May 2019. Single-bundle reconstructions using
autologous hamstring tendon grafts were performed in all patients. The
patients were randomized into 2 groups: the TXA group (received the index
procedure with 100-mL IA injection of TXA [30 mg/mL]) and a control group
(did not receive IA injection of TXA). No patients received a drain. Blood
loss was calculated on the basis of hemoglobin balance at postoperative day
(PD) 2. The visual analog scale (VAS) for pain score was assessed at PD 3.
The midpatellar circumference was measured at PD 2 and PD 5. Knee range of
motion (ROM) was evaluated 6 weeks after surgery.
Results:
The mean ± SD blood loss was 467 ± 242 mL in the TXA group and 558 ± 236 mL
in the control group. No significant differences were found for blood loss
(P = .20), VAS pain scores (P = .28),
ROM at postoperative week 6 (P = .61), or patellar
circumference at PD 2 (P = .75) and PD 5
(P = .84).
Conclusion:
This study showed that IA administration of 3.0 g of TXA had no effect in
reducing blood loss and postoperative pain after primary anatomic
single-bundle ACL reconstruction using quadruple hamstring autografts.
Registration:
NCT04042688 (ClinicalTrials.gov
identifier).
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