RESUMO
OBJECTIVES: This study aims to compare the efficiency and safety of intraarticular and intravenous tranexamic acid administration in patients who were performed primary total knee arthroplasty. PATIENTS AND METHODS: This single center, randomized, controlled trial included 60 patients (8 males, 52 females; mean age 67.8 years; range 53 to 87 years) who were performed primary total knee arthroplasty by three surgeons due to a diagnosis of primary osteoarthritis between January 2015 and June 2015. Patients were separated into three groups. Patients in group 1 and group 2 were administered 2 g intravenous tranexamic acid and 2 g intraarticular tranexamic acid, respectively. Patients in group 3 were not administered tranexamic acid. Pre- and postoperative hemoglobin difference, volume of blood collected in drains, and transfusion rate were analyzed. RESULTS: Compared with the control group, there was no significant difference between group 1 and group 2 in terms of total blood loss from the drain, pre- and postoperative hemoglobin difference, and the need for blood transfusion. CONCLUSION: Both intraarticular and intravenous administrations reduce blood loss and need for transfusion and there is no significant difference between the two techniques in terms of safety.
Assuntos
Perda Sanguínea Cirúrgica , Osteoartrite , Ácido Tranexâmico/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Antifibrinolíticos/administração & dosagem , Artroplastia do Joelho/métodos , Perda Sanguínea Cirúrgica/prevenção & controle , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Transfusão de Sangue , Monitoramento de Medicamentos , Feminino , Humanos , Infusões Intravenosas , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Osteoartrite/cirurgia , Período Pós-Operatório , Resultado do TratamentoRESUMO
Magnetic resonance imaging (MRI) is the preferred imaging technique to evaluate the intact, ruptured or healed anterior cruciate ligament (ACL). However, its effectiveness in the diagnosis of chronic tears with synovialization has not been searched. During conservative treatment of torn ACL, there is a reparative process with proliferation of synovial scar tissue which may produce a bridge. This healing, so called synovialization, may cause ACL to be misdiagnosed as intact on MRI. This is true for old ruptures of ACL. Magnetic resonance imaging is reliable in the evaluation of acute ACL ruptures. However, MRI is not reliable to evaluate the stability of the healed ACL after conservative treatment, and the ruptures due to degenerated ACLs.