An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety
Background. Recently, combined intra-articular tranexamic acid (IA-TXA) injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR). However, until now, none of previous studies revealed the effect of this technique on pharmacokinetic...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Hindawi Limited
2015-01-01
|
Series: | BioMed Research International |
Online Access: | http://dx.doi.org/10.1155/2015/164206 |
id |
doaj-b237af7409ad4180acc84ccdb5017457 |
---|---|
record_format |
Article |
spelling |
doaj-b237af7409ad4180acc84ccdb50174572020-11-24T21:33:06ZengHindawi LimitedBioMed Research International2314-61332314-61412015-01-01201510.1155/2015/164206164206An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and SafetyPaphon Sa-ngasoongsong0Pongsthorn Chanplakorn1Siwadol Wongsak2Krisorn Uthadorn3Tanapong Panpikoon4Paisan Jittorntam5Katcharin Aryurachai6Pantap Angchaisukisiri7Viroj Kawinwonggowit8Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandSection of Research, Education, and Innovation, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandDepartment of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, ThailandBackground. Recently, combined intra-articular tranexamic acid (IA-TXA) injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR). However, until now, none of previous studies revealed the effect of this technique on pharmacokinetics, coagulation, and fibrinolysis. Materials and Methods. An experimental study was conducted, during 2011-2012, in 30 patients undergoing unilateral TKR. Patients received IA-TXA application and then were allocated into six groups regarding clamping drain duration (2-, 4-, 6-, 8-, 10-, and 12-hours). Blood and drainage fluid were collected to measure tranexamic acid (TXA) level and related coagulation and fibrinolytic markers. Postoperative complication was followed for one year. Results. There was no significant difference of serum TXA level at 2 hour and 24 hour among groups (p<0.05). Serum TXA level at time of clamp release was significantly different among groups with the highest level at 2 hour (p<0.0001). There was no significant difference of TXA level in drainage fluid, postoperative blood loss, blood transfusion, and postoperative complications (p<0.05). Conclusions. Low-dose IA-TXA application in TKR with prolonged clamping drain method is a safe and effective blood conservative technique with only minimal systemic absorption and without significant increase in systemic absorption over time.http://dx.doi.org/10.1155/2015/164206 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Paphon Sa-ngasoongsong Pongsthorn Chanplakorn Siwadol Wongsak Krisorn Uthadorn Tanapong Panpikoon Paisan Jittorntam Katcharin Aryurachai Pantap Angchaisukisiri Viroj Kawinwonggowit |
spellingShingle |
Paphon Sa-ngasoongsong Pongsthorn Chanplakorn Siwadol Wongsak Krisorn Uthadorn Tanapong Panpikoon Paisan Jittorntam Katcharin Aryurachai Pantap Angchaisukisiri Viroj Kawinwonggowit An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety BioMed Research International |
author_facet |
Paphon Sa-ngasoongsong Pongsthorn Chanplakorn Siwadol Wongsak Krisorn Uthadorn Tanapong Panpikoon Paisan Jittorntam Katcharin Aryurachai Pantap Angchaisukisiri Viroj Kawinwonggowit |
author_sort |
Paphon Sa-ngasoongsong |
title |
An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety |
title_short |
An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety |
title_full |
An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety |
title_fullStr |
An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety |
title_full_unstemmed |
An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety |
title_sort |
in vivo study of low-dose intra-articular tranexamic acid application with prolonged clamping drain method in total knee replacement: clinical efficacy and safety |
publisher |
Hindawi Limited |
series |
BioMed Research International |
issn |
2314-6133 2314-6141 |
publishDate |
2015-01-01 |
description |
Background. Recently, combined intra-articular tranexamic acid (IA-TXA) injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR). However, until now, none of previous studies revealed the effect of this technique on pharmacokinetics, coagulation, and fibrinolysis. Materials and Methods. An experimental study was conducted, during 2011-2012, in 30 patients undergoing unilateral TKR. Patients received IA-TXA application and then were allocated into six groups regarding clamping drain duration (2-, 4-, 6-, 8-, 10-, and 12-hours). Blood and drainage fluid were collected to measure tranexamic acid (TXA) level and related coagulation and fibrinolytic markers. Postoperative complication was followed for one year. Results. There was no significant difference of serum TXA level at 2 hour and 24 hour among groups (p<0.05). Serum TXA level at time of clamp release was significantly different among groups with the highest level at 2 hour (p<0.0001). There was no significant difference of TXA level in drainage fluid, postoperative blood loss, blood transfusion, and postoperative complications (p<0.05). Conclusions. Low-dose IA-TXA application in TKR with prolonged clamping drain method is a safe and effective blood conservative technique with only minimal systemic absorption and without significant increase in systemic absorption over time. |
url |
http://dx.doi.org/10.1155/2015/164206 |
work_keys_str_mv |
AT paphonsangasoongsong aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT pongsthornchanplakorn aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT siwadolwongsak aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT krisornuthadorn aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT tanapongpanpikoon aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT paisanjittorntam aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT katcharinaryurachai aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT pantapangchaisukisiri aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT virojkawinwonggowit aninvivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT paphonsangasoongsong invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT pongsthornchanplakorn invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT siwadolwongsak invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT krisornuthadorn invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT tanapongpanpikoon invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT paisanjittorntam invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT katcharinaryurachai invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT pantapangchaisukisiri invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety AT virojkawinwonggowit invivostudyoflowdoseintraarticulartranexamicacidapplicationwithprolongedclampingdrainmethodintotalkneereplacementclinicalefficacyandsafety |
_version_ |
1725954879490359296 |