THE EFFECT OF TRANEXAMIC ACID INJECTION ON HEMOGLOBIN LEVEL, ALBUMIN LEVEL, AND PAIN ON PATIENT RECEIVING TOTAL KNEE REPLACEMENT
Downloads
Background: The high number of knee osteoarthritis cases could lead arthroplasty more frequent. Total Knee Replacement (TKR) surgery procedure is at risk of massive bleeding. Bleeding can affect albumin levels and the onset of intra-compartment pressure on the nerves. The use of tranexamic acid could be done to reduce bleeding.
Objective: Proving the effect of intravenous tranexamic acid administration on patients who will undergo TKR surgery.
Methods: The experiment was conducted experimentally using primary laboratory data obtained before and after surgery in patient which will be performed TKR operation starting from April 2017.
Result: There are 64 patients who had undergone total knee replacement surgery. The mean preoperative hemoglobin in the tranexamic acid group and without tranexamic acid was 13.06±1.46g/dl and 12.44±0.87g/dl. The mean hemoglobin after surgery was 10.29 ±1.14 g/dl and 9.16±0.97 g/dl. In the group receiving tranexamic acid, 32 (100%) reported low postoperative VAS scores, did not require blood transfusions and did not require albumin transfusion. Groups not receiving tranexamic acid, 32 (100%) moderate postoperative VAS scores, 4 people (12.5%) required the blood transfusion, and 3 (9.4%) required transfusion of albumin.
Conclusion: The results of this study showed that the group given tranexamic acid had higher hemoglobin levels after surgery than the untreated group of tranexamic acid; there was no difference in albumin levels after surgery in both groups; the administration of tranexamic acid will decrease the amount of blood loss, decrease the degree of pain, and decrease the need for blood transfusions after total knee replacement surgery.Ganvir SD, Zambare BR. Prevalence and identification of risk factors for knee osteoarthritis among elderly men and women. Sch J Applied Med Sci. 2013;1(6):700-703.
Yoo JJ, Kim DH, Kim HA. Risk factors for progression of radiographic knee osteoarthritis in elderly community residents in Korea. 2018:1-7.
Dang PP, Schwarzkopf R. Tranexamic acid and total knee arthroplasty. Ann Orthop Rheumatol. 2013;1(1):1001.
Cundy WJ, Theodoulou MA, Ling CM, et al. Blood Loss in Total Knee Arthroplasty. 2016;1(212).
Da H, Pa C, Aj M, et al. Anti-fibrinolytic use for minimising perioperative allogeneic blood transfusion (Review). 2011;(1).
Roberts I, Shakur H, Afolabi A, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomized controlled trial. Lancet (London, England). 2011; 377(9771):1096-1101, 1101-2.
Li ZJ, Zhao MW, Zeng L. Additional Dose of Intravenous Tranexamic Acid after Primary Total Knee Arthroplasty Further Reduces Hidden Blood Loss. 2018;131(6):638-643.
Dahuja A, Bhowmik S, Kaur R, Shayam R. Antifibrinolytic in reducing postoperative blood loss in total hip replacement and its effect on coagulation profile : A prospective randomized study. 2018:3-8.
Graven-Nielsen T, McArdle A, Phoenix J, Arendt-Nielsen L, Jensen TS, Jackson MJ, Edwards RH. In vivo model of muscle pain: quantification of intramuscular chemical, electrical, and pressure changes associated with saline-induced muscle pain in humans. Pain. 1997 Jan 1;69(1-2):137-43.
Fu DJ, Chen C, Guo L, Yang L. Use of intravenous tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials. Chin J Traumatol. 2013;16(2):67-76.
Yang ZG, Chen WP, Wu LD. Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty: a meta-analysis. J Bone Joint Surg Am. 2012;94(13):1-7.
Triyudanto AN, Lubis AMT. The effects of intra-articular tranexamic acid given intraoperatively and intravenous tranexamic acid given preoperatively on post surgical bleeding and transfusion rate post total knee arthroplasty. Med J Indones. 2016;25(4):234-239.
Breugem SJM, Haverkamp D. Anterior knee pain after a total knee arthroplasty: What can cause this pain? World J Orthop. 2014;5(3):163-170.
Kamath AF, Nelson CL, Elkassabany N, Guo Z, Liu J. Low albumin is a risk factor for complications after revision total knee arthroplasty. J Knee Surg. 2017;30(3):269-275.
Levitt DG, Levitt MD. Human serum albumin homeostasis: a new look at the roles of synthesis, catabolism, renal and gastrointestinal excretion, and the clinical value of serum albumin measurements. 2016.
Hawker G, Mian S, Kendzerska T, et al. Measures of adult pain. Arthritis Care Res. 2011;63(11):240-252.
Moghtadaei M, Shahoseini GR. Risk Factors for Blood Loss Following Total Knee Arthroplasty. 2014; 1(4):1-5
Banerjee S, Issa K, Kapadia BH, et al. Intraoperative non pharmacotherapeutic blood management strategies in total knee arthroplasty. J Knee Surg. 2013;26:387-93.
José Wanderley Vasconcelos Gdava. Blood Loss in Total Knee Arthroplasty with and Without Tourniquet Release. 2011; 19(1):32-36.
Sahu S, Hemiata, Verma A. Adverse events related to blood transfusion. 2014; 58(5).
Schlenke P. Patient Blood Management: It is Time to Streamline. 2015:72-73.
Bower WF, Jin L, Underwood MJ, et al. Perioperative blood transfusion increases length of hospital stay and number of postoperative complications in non-cardiac surgical patients. Hong Kong Med J. 2010;16:116 20.
Kerakkanavar S, Venkatesh R, Gopinath KM, Pramodkumar M, Kerakkanavar S. Effect of intravenous tranexamic acid on blood loss and blood transfusion in total knee replacement: a prospective, randomized study in Indian population. Orthop JR. 2017; 3(5):916-921.
Xu J, Wang L, Ma X. Comparison of efficacy and safety of fibrin glue versus tranexamic acid for reducing blood loss in primary total knee arthroplasty: a systematic review and meta-analysis. 2016; 9(2):1236-1244.
Aslam KS, Niazi AK, Nabi O. Efficacy of tranexamic acid in reducing blood loss in total knee replacements S-211. 2015:210-214.
Kamath AF, Nelson CL, Elkassabany N, et al. Low albumin is a risk factor for complications after revision total knee arthroplasty. J Knee Surg 2017; 30(03): 269-275.
Grosso MJ, Trofa DP, Danoff JR, et al. Tranexamic acid increases early perioperative functional outcomes after total knee arthroplasty. Arthroplasty Today xxx (2017) 1e4.
Pauzenberger L, Domej MA, Heuberer PR, Hexel M, Grieb A, Laky B, Blasl J, Anderl W. The effect of intravenous tranexamic acid on blood loss and early post-operative pain in total shoulder arthroplasty. The bone & joint journal. 2017 Aug;99(8):1073-9.
Guerreiro JP, Badaro BS, Balbino JR, Danieli MV, Queiroz AO, Cataneo DC. Application of Tranexamic Acid in Total Knee Arthroplasty–Prospective Randomized Trial. The open orthopaedics journal. 2017;11:1049.
- The author acknowledges that the copyright of the article is transferred to the Journal of Orthopaedi and Traumatology Surabaya (JOINTS), whilst the author retains the moral right to the publication.
- The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution-Non Commercial-Share Alike 4.0 International License (CC BY-NC-SA).
- All published manuscripts, whether in print or electronic form, are open access for educational, research, library purposes, and non-commercial uses. In addition to the aims mentioned above, the editorial board is not liable for any potential violations of copyright laws.
- The form to submit the manuscript's authenticity and copyright statement can be downloaded here.
Journal of Orthopaedi and Traumatology Surabaya (JOINTS) is licensed under a Creative Commons Attribution-Non Commercial-Share Alike 4.0 International License.
Journal Orthopaedi and Traumatology Surabaya (JOINTS) (