2022, Vol. 26 ›› Issue (36): 5857-5861

Different doses of tranexamic acid affect blood loss after high tibial osteotomy

Sun Yiyuan1, Li Qi2, Xiong Yan2, Li Jian2   

Abstract: BACKGROUND: Tranexamic acid has been widely used in hip and knee replacements, which could reduce blood on the bone surface. In recent years, the drug has also achieved certain results in high tibial osteotomies. However, how to choose the dosage and assess the risk and benefit is not yet known.
OBJECTIVE: To evaluate the effect of different doses of tranexamic acid on blood loss after high tibial osteotomy.
METHODS: The clinical data of 62 patients with varus knee joint deformity who received unilateral high tibial osteotomy in West China Hospital of Sichuan University from March 2018 to July 2021 were collected. According to different doses of tranexamic acid, the patients were divided into low-dose group of 22 cases, medium-dose group of 20 cases, and high-dose group of 20 cases. Tranexamic acid was administered intravenously. Patients in the low-dose group and medium-dose group received intravenous infusion of 1 g or 2 g tranexamic acid solution 30 minutes before surgery. Patients in the high-dose group received another infusion of 1 g tranexamic acid 3 hours after surgery on the basis of the medium-dose group. The difference of hematological indexes among the three groups before and after surgery was collected and compared. Operation duration, postoperative blood transfusion volume, incision complications, and thromboembolic events were recorded and compared among the three groups.
RESULTS AND CONCLUSION: (1) There was no significant difference in hemoglobin changes and blood loss between the low-dose group and the middle-dose group before and after the operation, but the hemoglobin loss of the high-dose group was significantly less than that of the low-dose group. Blood loss was significantly less in the middle-dose and high-dose groups than that of the low-dose group (P < 0.05). (2) The differences in prothrombin time, fibrinogen, and activated prothrombin time were not significantly different before and after the operation in patients of the three groups (P > 0.05). (3) There were no incision infections or thromboembolic events after the operation in the three groups, and there was no significant difference in complications. (4) It is concluded that perioperative use of high-dose tranexamic acid for high tibial osteotomy can significantly reduce blood loss, and does not increase postoperative incision complications and thromboembolic events.
Key words: high tibial osteotomy, tranexamic acid, blood loss, varus deformity, incision complications, thromboembolism