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Objectives: The standard surgical method for primary gonarthrosis in advanced stages is total knee arthroplasty (TKA), despite the risk of bleeding that requires transfusion. Blood transfusions are potentially dangerous. The aim of this study was to determine whether there is a statistical difference in the amount of bleeding and the need for transfusion between patients who received and did not receive perioperative local tranexamic acid in TKA. Methods: The hospital data system was used to access the data of patients who underwent TKA in our clinic between January 2015 and January 2022 with a diagnosis of gonarthrosis. Patients who underwent TKA and had gonarthrosis as the primary diagnosis were included in the study. They were separated into two groups: A control group (Group C) and a group that received perioperative local tranexamic acid (Group LTXA). The amount of bleeding was compared by taking into account patients' hemogram follow-ups, the amount of blood from their drains, and their transfusion needs during the postoperative period. Results: The findings demonstrated that TKA patients who received local tranexamic acid administration experienced a significant decrease in perioperative blood loss and needed lesser transfusions. Conclusion: The findings of our investigation are consistent with other studies and are in favor of the usage of TXA in TKA. To validate our findings and establish the ideal TXA dosage and administration method in TKA, additional research is required.
RESUMO
Aim: Coal miners are more prone to musculoskeletal injuries to their knees due to specific repetitive movements while working in the seams. We aimed to identify the kinds of and quantify traumatic musculoskeletal injuries to the knee in the coal miners. Methods: A retrospective observational analysis of all consecutive emergency admissions of the coal miners with occupational knee injuries between January 2018 and December 2020 was performed. A total of 94 knee trauma events in 79 knees of 76 patients were analyzed in the study. Musculoskeletal injuries of the meniscal and ligamentous/tendinous structures were identified using magnetic resonance imaging of the affected knees. Results: The medial meniscal and the anterior cruciate ligament injuries were detected in 72.3% and 51.1% of the events, respectively. Grade 2 and 3 medial meniscal injuries were the most common grades (39.7% and 41.2%, respectively). For the anterior cruciate ligament injuries, grade 2 was the most common (56.3%). In 48.9% of the cases, we detected bony bruise/edema in the tibial plateau (52.2%), and the condyles of the femur (45.7%) were almost equally affected. Intraarticular effusions appeared in 59.6% of the cases. Conclusions: Our findings provide detailed identification of the injuries seen in the coal miners. The medial meniscus and the anterior cruciate ligament are the most frequently injured structures.
RESUMO
BACKGROUND: Tranexamic acid (TXA) is an antifibrinolytic agent. It has long been used to reduce the need for perioperative blood loss in various surgeries. Few studies have investigated the effects of local and intravenous administration of TXA on fracture healing. Thus, we aimed to evaluate if TXA influences hematoma volume and fracture healing in the rat tibia fracture model. MATERIALS AND METHODS: A tibia fracture with intramedullary Kirschner wire fixation was created in all animals. Rats were randomly divided into three groups as local TXA, intravenous TXA, and control. A dose of 50 mg/kg local and intravenous TXA was administered to the study groups. Hematoma volume was measured on the first and third days of the study. The animals were sacrificed on the 14th and 21st days for radiological and histopathological examinations. RESULTS: There was no significant difference between the groups in terms of hematoma volume measured on Day 1 and the mean decrease of hematoma volume from Day 1 to Day 3 (p = 0.158 and p = 0.239, respectively). The total radiological scores of Day 14 and Day 21 were similar in all groups (p > 0.05 for all). There was also no significant difference between the histological staging of the fracture repair on Day 14 and Day 21 for all groups (p > 0.05 for all). CONCLUSION: Our findings suggest that TXA's local and intravenous application makes no significant difference in fracture healing.
