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Administration of Tranexamic Acid Improves Long-Term Outcomes in Total Knee Arthroplasty.
Drain, Nicholas P; Gobao, Valerie C; Bertolini, Dominique M; Smith, Clair; Shah, Neel B; Rothenberger, Scott D; Dombrowski, Malcolm E; O'Malley, Michael J; Klatt, Brian A; Hamlin, Brian R; Urish, Kenneth L.
Afiliação
  • Drain NP; University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Gobao VC; University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Bertolini DM; University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Smith C; Department of Physical Therapy and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Shah NB; Division of Infectious Disease, Department of Internal Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Rothenberger SD; Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA.
  • Dombrowski ME; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
  • O'Malley MJ; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
  • Klatt BA; Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA.
  • Hamlin BR; The Bone & Joint Center, Magee Womens Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA.
  • Urish KL; Arthritis and Arthroplasty Design Group, The Bone and Joint Center, Magee Womens Hospital of the University of Pittsburgh Medical Center, Department of Orthopaedic Surgery, Department of Bioengineering, and Clinical and Translational Science Institute, University of Pittsburgh; Department of Biomedi
J Arthroplasty ; 35(6S): S201-S206, 2020 06.
Article em En | MEDLINE | ID: mdl-32209286
BACKGROUND: Blood transfusion in total knee arthroplasty (TKA) is associated with increased morbidity, including periprosthetic joint infection (PJI). Tranexamic acid (TXA) reduces blood transfusion rates, but there is limited evidence demonstrating improved outcomes in TKA resulting from TXA administration. The objectives of this study are determining whether TXA is associated with decreased rate of PJI, decreased rate of outcomes associated with PJI, and whether there are differences in rates of adverse events. METHODS: A multicenter cohort study comprising 23,421 TKA compared 4423 patients receiving TXA to 18,998 patients not receiving TXA. Primary outcome was PJI within 2 years of TKA. Secondary outcomes included revision surgery, irrigation and debridement, transfusion, and length of stay. Adverse events included readmission, deep vein thrombosis, pulmonary emboli, myocardial infarction, or stroke. Adjusted odds ratios were determined using linear mixed models controlling for age, sex, thromboembolic prophylaxis, Charlson comorbidity index, year of TKA, and surgeon. RESULTS: TXA administration reduced incidence of PJI by approximately 50% (odds ratio [OR], 0.55; P = .03). Additionally, there was decreased incidence of revision surgery at 2 years (OR, 0.66; P = .02). Patients receiving TXA had reductions in transfusion rate (OR, 0.15; P < .0001) and length of stay (P < .0001). There was no difference in the rate of pulmonary emboli (OR, 1.20; P = .39), myocardial infarction (OR, 0.78; P = .55), or stroke (OR, 1.17; P = .77). CONCLUSION: Administration of TXA in TKA resulted in reduced rate of PJI and overall revision surgery. No difference in thromboembolic events were observed. The use of TXA is safe and improves outcomes in TKA. LEVEL OF EVIDENCE: Level III, Observational Cohort Study.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ácido Tranexâmico / Artroplastia do Joelho / Antifibrinolíticos Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ácido Tranexâmico / Artroplastia do Joelho / Antifibrinolíticos Tipo de estudo: Clinical_trials / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: J Arthroplasty Assunto da revista: ORTOPEDIA Ano de publicação: 2020 Tipo de documento: Article País de publicação: Estados Unidos