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Tranexamic acid is beneficial for blood management of high tibial osteotomy: a randomized controlled study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study was to investigate whether TXA can effectively reduce blood loss after HTO and related complications and to evaluate its safety.

Materials and methods

From March 2016 to March 2018, 100 patients who underwent medial opening wedge HTO in the Department of Orthopedics, the second affiliated hospital of xi’an jiaotong university, with an average age of 52.8 ± 3.2 years, were randomly divided into the TXA group (using intravenous TXA) and the control group (using the same amount of normal saline), with 50 patients in each group. The postoperative wound drainage volume, decrease in hemoglobin and hematocrit value, total blood loss, wound healing, blood transfusion, deep venous thrombosis (DVT) and pulmonary embolism (PE) were compared between the two groups.

Results

The drainage volume on the first postoperative day and the total drainage volume of the TXA group were significantly lower compared with those of the control group (145.7 vs 264.5 ml, 282.3 vs 413.2 ml, P < 0.05). The decreases in the hemoglobin and hematocrit values on the postoperative first, second and fifth days were lower in the TXA group than those in the control group (1.4 VS 3.5, 2.6 vs 3.3, 1.9 vs 2.9 g, P < 0.05; 3.3 vs 5.5, 5.0 vs 9.1, 3.8 vs 7.2%, P < 0.05), and the mean total blood loss was also lower in the TXA group than that in the control group (477.9 vs 834.6 ml, P < 0.05). In the control group, 1 patient had wound hematoma requiring additional paracentesis and pressure dressing, 1 patient had superficial wound infection requiring additional debridement, and 1 patient had postoperative blood transfusion compared to none in the TXA group (P > 0.05). There was no symptomatic DVT or PE in either of the groups.

Conclusion

Intravenous TXA can effectively and safely reduce blood loss and bleeding-related complications after HTO and was beneficial for the blood management of HTO.

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Acknowledgements

The authors thank AJE (American Journal Experts) for the help in English language editing of the manuscript.

Funding

This study was supported by the general project of key research and development program of Shaanxi provincial (2019SF-113).

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Authors and Affiliations

  1. Department of Orthopedics, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710004, Shaanxi, China

    Jianlong Ni, Juan Liu, Jing Zhang, Juan Jiang, Xiaoqian Dang & Zhibin Shi

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  1. Jianlong Ni
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by JN, JL, JZ, JJ, XD and ZS. The first draft of the manuscript was written by JN and ZS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zhibin Shi.

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Ni, J., Liu, J., Zhang, J. et al. Tranexamic acid is beneficial for blood management of high tibial osteotomy: a randomized controlled study. Arch Orthop Trauma Surg 141, 1463–1472 (2021). https://doi.org/10.1007/s00402-020-03558-5

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