Abstract
Background
Anterior Cruciate Ligament (ACL) reconstruction is a common surgery in orthopedics. Strategies that could reduce the bleeding during the surgery could be helpful. Here, we aimed to assess the effects of tranexamic acid injection in ACL reconstruction on patient’s functions.
Methods
This is a clinical trial performed in 2019–2020 in XX on 61 patients with teared ACL who were candidates of surgical reconstruction. Patients were divided into two groups receiving 15 mg/kg of intravenous tranexamic acid and normal saline. Data regarding the following items were collected: amounts of drain discharge, the severity of the swelling, the pain severity in 1, 7 and 14 days after the surgeries and restrictions in joint range of motion (ROM) in 30 and 60 days after the surgeries.
Results
We observed significantly lower swelling severities in patients who received tranexamic acid in different measuring times (P = 0.029). These cases also had significantly lower pain severity after 30 days post-operation (P = 0.041). We also observed that patients in the tranexamic acid group had significantly lower ROM restriction than controls (P < 0.001). The total knee scores were similar in both groups (P > 0.05).
Conclusion
Administration of intravenous tranexamic acid significantly improved swelling, pain and lower ROM restriction in patients undergoing ACL reconstruction.
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References
Musahl V, Karlsson J (2019) Anterior cruciate ligament tear. N Engl J Med 380(24):2341–2348
Mahapatra P, Horriat S, Anand BS (2018) Anterior cruciate ligament repair–past, present and future. J Exp Orthop 5(1):1–10
Shea KG, Carey JL, Richmond J, Sandmeier R, Pitts RT, Polousky JD et al (2015) Management of anterior cruciate ligament injuries. J Bone Joint Surg Am 97(8):672–676
Samitier G, Marcano AI, Alentorn-Geli E, Cugat R, Farmer KW, Moser MW (2015) Failure of anterior cruciate ligament reconstruction. Arch Bone Joint Surg 3(4):220
Tepolt FA, Feldman L, Kocher MS (2018) Trends in pediatric ACL reconstruction from the PHIS database. J Pediatr Orthop 38(9):e490–e494
Rahnemai-Azar AA, Sabzevari S, Irarrázaval S, Chao T, Fu FH (2016) Anatomical individualized ACL reconstruction. Arch Bone Joint Surg 4(4):291
Cruz AI, Fabricant PD, McGraw M, Rozell JC, Ganley TJ, Wells L (2017) All-epiphyseal ACL reconstruction in children: review of safety and early complications. J Pediatr Orthop 37(3):204–209
Eckenrode BJ, Carey JL, Sennett BJ, Zgonis MH (2017) Prevention and management of post-operative complications following ACL reconstruction. Curr Rev Musculoskelet Med 10(3):315–321
Rousseau R, Labruyere C, Kajetanek C, Deschamps O, Makridis KG, Djian P (2019) Complications after anterior cruciate ligament reconstruction and their relation to the type of graft: a prospective study of 958 cases. Am J Sports Med 47(11):2543–2549
Ng WCK, Jerath A, Wasowicz M (2015) Tranexamic acid: a clinical review. Anaesthesiol Intens Therapy 47(4):339–350
Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T et al (2017) Tranexamic acid in patients undergoing coronary-artery surgery. N Engl J Med 376(2):136–148
Tan TK, Ng KT, Lim HJ, Radic R (2021) Effect of tranexamic acid in arthroscopic anterior cruciate ligament repair: a systematic review and meta-analysis of randomised clinical trials. J Orthop Surg 29(2):23094990211017350
Chiang E-R, Chen K-H, Wang S-T, Ma H-L, Chang M-C, Liu C-L et al (2019) Intra-articular injection of tranexamic acid reduced postoperative hemarthrosis in arthroscopic anterior cruciate ligament reconstruction: a prospective randomized study. Arthrosc J Arthrosc Relat Surg 35(7):2127–2132
Prejbeanu R, Mioc ML, Deleanu B, Balanescu A, Al Qatawneh M, Malita D (2021) The use of tranexamic acid in anterior cruciate ligament reconstruction: a systematic review. Appl Sci 11(23):11518
Haratian A, Shelby T, Hasan LK, Bolia IK, Weber AE, Petrigliano FA (2021) Utilization of tranexamic acid in surgical orthopaedic practice: indications and current considerations. Orthop Res Rev 13:187
Rodriguez-Merchan EC (2020) Does intravenous or intraarticular tranexamic acid (TXA) reduce joint bleeding following arthroscopic anterior cruciate ligament (ACL) reconstruction and arthroscopic meniscectomy? can intraarticular use be harmful to chondrocytes? Arch Bone Joint Surg 8(5):557
Felli L, Revello S, Burastero G, Gatto P, Carletti A, Formica M et al (2019) Single intravenous administration of tranexamic acid in anterior cruciate ligament reconstruction to reduce postoperative hemarthrosis and increase functional outcomes in the early phase of postoperative rehabilitation: a randomized controlled trial. Arthrosc J Arthrosc Relat Surg 35(1):149–157
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This study was granted by Isfahan University of Medical Sciences.
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Mousavi, H., Akbari-Aghdam, H. & Entezari, R. The effect of tranexamic acid injection during anterior cruciate ligament reconstruction surgery on postoperative bleeding, pain and swelling. Eur J Orthop Surg Traumatol 33, 639–644 (2023). https://doi.org/10.1007/s00590-022-03318-8
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DOI: https://doi.org/10.1007/s00590-022-03318-8