Resumo

BIDOLEGUI, Fernando M; PEREIRA, Sebastián P; LUGONES, Alfonso  e  VINDVER, Gabriel I. Ácido tranexámico endovenoso en el reemplazo total de rodilla sin manguito hemostático: Estudio prospectivo aleatorizado. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2014, vol.79, n.3, pp.154-162. ISSN 1852-7434.

Background: Total knee arthroplasty is associated with peri- and postoperative blood loss (600 to 1500 mL) and with blood transfusion rates of up to 50%. The objective is to study the effect of tranexamic acid in total knee arthroplasty without tourniquet, taking into account the blood loss in the postoperative period. Method: Patients were randomized into two groups: Group A, with tranexamic acid, 25 patients (71.5 years old) and Group B, without tranexamic acid, 25 patients (72 years old). Hemoglobin and hematocrit were evaluated prior to surgery and after 24, 48 and 72 hours. Drainage was evaluated after 24 hours. Results: The postoperative hematocrit after 24, 48 and 72 hours was 33.4%, 31.5% and 30.8%, respectively, in Group A, and 28.5%, 27.9% and 27%, respectively, in Group B (p <0.001 in the 3 registers). Hemoglobin values were 11, 10.3 and 10 g/dL, respectively, in Group A and 9.4, 9.3 and 9 g/dL, in Group B (p <0.001, p = 0.004 and p = 0.002). Drainage after 24 hours in Group A was 363.4 mL (± 141 mL) and 626 mL (± 260 mL) in Group B (p <0.001). Thirty two patients in Group B underwent transfusion, while none in group A. No cases of thromboembolic disease were detected. Conclusion: Tranexamic acid use decreases postoperative bleeding associated with total knee arthroplasty, resulting in lower transfusion rates without an increase in complication risks.

Palavras-chave : Tranexamic acid; Total knee arthroplasty; Tourniquet.

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