THE USE OF TRANEXAMIC ACID IN ARTHOPLASTY OF LARGE JOINTS (LITERATURE REVIEW)

Authors

  • Volodymyr Filipenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-5698-2726
  • Olga Pidgaiska Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-5025-977X
  • Karolina Poplavska Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine
  • Stanislav Hubskyi Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872021369-74

Keywords:

Tranexamic acid, intravenous and intra-atricular injection, dose-response effect, large orthopedic surgical treatment, blood loss

Abstract

Endoprosthesis of large joints is an efficient method to restore the functional capacity of a limb, to increase the patientʼs motor activity, to eliminate the pain syndrome and to recover self-service. However, there is a risk of certain complications, one of which is massive blood loss. There have been recent publications on the feasibility of the use of tranexamic acid in the arthroplasty of large joints to prevent and reduce blood loss. The objective is to identify
the trends in the use of tranexamic acid in orthopedics and traumatology to prevent blood loss in the arthroplasty of large joints without increasing the risk of other complications. Methods. The search for the scientific information was conducted in Google Scholar, PubMed, World Digital Library, ScienceDirect. Results. The literature review is devoted to the topical issue of the present dayʼs orthopedics, which is the use of tranexamic acid to prevent blood
loss in arthroplasty of large joints. According to the studies, the use of tranexamic acid significantly reduces the overall blood loss without increasing the risk of complications such as thromboembolism. The risk of complications of infectious genesis and of those due to the blood transfusion is also reduced using tranexamic acid. It is determined that the combined intra-articular and intravenous injection of tranexamic acid is more efficient than the application
of either method separately. However, the comparative results of the ways of administration and the dosage regimen are quite ambiguous. The question of the optimum dose of the medication, which would provide maximum efficiency, without increasing the risk of complications is still to establish. It is advisable to conduct further research on the use of tranexamic acid to determine the efficiency of the ways of injection, dosing regimen taking into account
the patients' demographic features, their age, concomitant pathology, time of surgery and other factors.

Author Biographies

Volodymyr Filipenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Orthopaedics and Traumatology

Olga Pidgaiska, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, PhD in Traumatology and Orthopaedics

Karolina Poplavska, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD

Stanislav Hubskyi, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD

References

  1. Huang, Z., Ma, J., Shen, B., & Pei, F. (2014). Combination of intravenous and topical application of Tranexamic acid in primary total knee arthroplasty: A prospective randomized controlled trial. The Journal of Arthroplasty, 29(12), 2342-2346. https://doi.org/10.1016/j.arth.2014.05.026
  2. Rasouli, M. R., Maltenfort, M. G., Erkocak, O. F., Austin, M. S., Waters, J. H., & Parvizi, J. (2016). Blood management after total joint arthroplasty in the United States: 19-year trend analysis. Transfusion, 56(5), 1112-1120. https://doi.org/10.1111/trf.13518
  3. Davey, J. R., Kim, C., & Park, S. S. (2015). Tranexamic acid for the prevention and management of orthopedic surgical hemorrhage: Current evidence. Journal of Blood Medicine, 239. https://doi.org/10.2147/jbm.s61915
  4. Sun, Q., Li, J., Chen, J., Zheng, C., Liu, C., & Jia, Y. (2019). Comparison of intravenous, topical or combined routes of tranexamic acid administration in patients undergoing total knee and hip arthroplasty: A meta-analysis of randomised controlled trials. BMJ Open, 9(1), e024350. https://doi.org/10.1136/bmjopen-2018-024350
  5. Fillingham, Y. A., Ramkumar, D. B., Jevsevar, D. S., Yates, A. J., Bini, S. A., Clarke, H. D., ... & Della Valle, C. J. (2018). Tranexamic acid use in total joint arthroplasty: The clinical practice guidelines endorsed by the American Association of hip and knee surgeons, American society of Regional Anesthesia and Pain Medicine, American Academy of orthopaedic surgeons, hip society, and knee society. The Journal of Arthroplasty, 33(10), 3065-3069. https://doi.org/10.1016/j.arth.2018.08.002
  6. Kim, T. K., Chang, C. B., & Koh, I. J. (2013). Practical issues for the use of tranexamic acid in total knee arthroplasty: A systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, 22(8), 1849-1858. https://doi.org/10.1007/s00167-013-2487-y
  7. Nemoto, A., Mizuno, K., & Goyagi, T. (2020). The effect of Tranexamic acid administration on perioperative bleeding in patients undergoing knee or hip arthroplasty: A single-centre retrospective study. The Turkish Journal of Anaesthesiology and Reanimation, 142-147. https://doi.org/10.5152/tjar.2019.08364
  8. Xu, S., Chen, J. Y., Zheng, Q., Lo, N. N., Chia, S., Tay, K. J., ... & Yeo, S. J. (2019). The safest and most efficacious route of tranexamic acid administration in total joint arthroplasty: A systematic review and network meta-analysis. Thrombosis Research, 176, 61-66. https://doi.org/10.1016/j.thromres.2019.02.006
  9. Alshryda, S., Sukeik, M., Sarda, P., Blenkinsopp, J., Haddad, F. S., & Mason, J. M. (2014). A systematic review and meta-analysis of the topical administration of tranexamic acid in total hip and knee replacement. The Bone & Joint Journal, 96-B(8), 1005-1015. https://doi.org/10.1302/0301-620x.96b8.33745
  10. Pabinger, I., Fries, D., Schöchl, H., Streif, W., & Toller, W. (2017). Tranexamic acid for treatment and prophylaxis of bleeding and hyperfibrinolysis. Wiener klinische Wochenschrift, 129(9-10), 303-316. https://doi.org/10.1007/s00508-017-1194-y
  11. Xiong, H., Liu, Y., Zeng, Y., Wu, Y., & Shen, B. (2018). The efficacy and safety of combined administration of intravenous and topical tranexamic acid in primary total knee arthroplasty: A meta-analysis of randomized controlled trials. BMC Musculoskeletal Disorders, 19(1). https://doi.org/10.1186/s12891-018-2181-9
  12. Katsumata, S., Nagashima, M., Kato, K., Tachihara, A., Wauke, K., Saito, S., ... & Yoshino, S. (2005). Changes in coagulation-fibrinolysis marker and neutrophil elastase following the use of tourniquet during total knee arthroplasty and the influence of neutrophil elastase on thromboembolism. Acta Anaesthesiologica Scandinavica, 49(4), 510-516. https://doi.org/10.1111/j.1399-6576.2005.00621.x
  13. Ockerman, A., Vanassche, T., Garip, M., Vandenbriele, C., Engelen, M. M., Martens, J., ... & Verhamme, P. (2021). Tranexamic acid for the prevention and treatment of bleeding in surgery, trauma and bleeding disorders: A narrative review. Thrombosis Journal, 19(1). https://doi.org/10.1186/s12959-021-00303-9
  14. Li, J., Li, H., Zhao, H., Wang, J., Liu, S., Song, Y., & Wu, H. (2017). Combined use of intravenous and topical versus intravenous tranexamic acid in primary total knee and hip arthroplasty: A meta-analysis of randomised controlled trials. Journal of Orthopaedic Surgery and Research, 12(1). https://doi.org/10.1186/s13018-017-0520-4
  15. Sculco, T. P., Baldini, A., & Keating, E. M. (2005). Blood management in total joint arthroplasty. Instructional course lectures, 54, 51–66
  16. Kozek-Langenecker, S. A., Ahmed, A. B., Afshari, A., Albaladejo, P., Aldecoa, C., Barauskas, G., … & Zacharowski, K. (2017). Management of severe perioperative bleeding. European Journal of Anaesthesiology, 34(6), 332-395. https://doi.org/10.1097/eja.0000000000000630
  17. Yang, Z., Chen, W., & Wu, L. (2012). Effectiveness and safety of Tranexamic acid in reducing blood loss in total knee arthroplasty. The Journal of Bone & Joint Surgery, 94(13), 1153-1159. https://doi.org/10.2106/jbjs.k.00873
  18. Chen, S., Wu, K., Kong, G., Feng, W., Deng, Z., & Wang, H. (2016). The efficacy of topical tranexamic acid in total hip arthroplasty: A meta-analysis. BMC Musculoskeletal Disorders, 17(1). https://doi.org/10.1186/s12891-016-0923-0
  19. Fillingham, Y. A., Ramkumar, D. B., Jevsevar, D. S., Yates, A. J., Shores, P., Mullen, K., ... & Della Valle, C. J. (2018). The efficacy of Tranexamic acid in total knee arthroplasty: A network meta-analysis. The Journal of Arthroplasty, 33(10), 3090-3098.e1. https://doi.org/10.1016/j.arth.2018.04.043
  20. Nilsson, I. M. (1980). Clinical pharmacology of aminocapronic and tranexamic acids. Journal of clinical patho­logy. Supplemen, 14, 41–47.
  21. Sukeik, M., Alshryda, S., Haddad, F. S., & Mason, J. M. (2011). Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. The Journal of Bone and Joint Surgery. British volume, 93-B(1), 39-46. https://doi.org/10.1302/0301-620x.93b1.24984
  22. Xie, J., Hu, Q., Huang, Q., Ma, J., Lei, Y., & Pei, F. (2017). Comparison of intravenous versus topical tranexamic acid in primary total hip and knee arthroplasty: An updated meta-analysis. Thrombosis Research, 153, 28-36. https://doi.org/10.1016/j.thromres.2017.03.009
  23. Wang, S., Gao, X., & An, Y. (2016). Topical versus intravenous tranexamic acid in total knee arthroplasty: A meta-analysis of randomized controlled trials. International Orthopaedics, 41(4), 739-748. https://doi.org/10.1007/s00264-016-3296-y
  24. Is combined topical with intravenous tranexamic acid superior than topical, intravenous tranexamic acid alone and control groups for blood loss controlling after total knee arthroplasty. (2017). Medicine, 96(7), e6208. https://doi.org/10.1097/md.0000000000006208
  25. Sculco, T. P., Colwell, C. W., Pellegrini, V. D., Westrich, G. H., & Böttner, F. (2002). Prophylaxis against venous thromboembolic disease in patients having a total hip or knee arthroplasty. The Journal of Bone and Joint Surgery-American Volume, 84(3), 466-477. https://doi.org/10.2106/00004623-200203000-00021
  26. Aguilera, X., Martínez-Zapata, M. J., Hinarejos, P., Jordán, M., Leal, J., González, J. C., ... & Puig-Verdie, L. L. (2015). Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: A multicenter, randomized, controlled trial. Archives of Orthopaedic and Trauma Surgery, 135(7), 1017-1025. https://doi.org/10.1007/s00402-015-2232-8
  27. Huang, Z., Ma, J., Pei, F., Yang, J., Zhou, Z., Kang, P., & Shen, B. (2013). Meta-analysis of temporary versus no clamping in TKA. Orthopedics, 36(7), 543-550. https://doi.org/10.3928/01477447-20130624-11
  28. Abdel, M. P., Chalmers, B. P., & Taunton, M. J. (2018). Taunton intravenous versus topical tranexamic acid in total knee arthroplasty both effective in a randomized clinical trial of 640 patients. The Journal of Bone and Joint Surgery. American volume, 100(1), 1023–1029. https://doi.org/10.2106/JBJS.17.00908.
  29. Saad, B. N., Menken, L. G., Elkattaway, S., Liporace, F. A., & Yoon, R. S. (2021). Tranexamic acid lowers transfusion requirements and hospital length of stay following revision total hip or knee arthroplasty. Patient Safety in Surgery, 15(1). https://doi.org/10.1186/s13037-021-00295-5

Downloads

How to Cite

Filipenko, V. ., Pidgaiska, O. ., Poplavska, K. ., & Hubskyi, S. . (2023). THE USE OF TRANEXAMIC ACID IN ARTHOPLASTY OF LARGE JOINTS (LITERATURE REVIEW). ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3), 69–74. https://doi.org/10.15674/0030-59872021369-74

Issue

No. 3 (2021)

Section

DIGESTS AND REVIEWS

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.

Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.

The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).