Elevated Pre-operative D-Dimer Levels Do Not Impact the Effect of Tranexamic Acid on Revision Total Knee Arthroplasty

John M Tarazi; Theofanis P Zois; Andrew Bohm; Michael A Mont; Giles R Scuderi

doi:10.1016/j.ocl.2021.12.001

Elevated Pre-operative D-Dimer Levels Do Not Impact the Effect of Tranexamic Acid on Revision Total Knee Arthroplasty

Orthop Clin North Am. 2022 Apr;53(2):139-143. doi: 10.1016/j.ocl.2021.12.001. Epub 2022 Mar 7.

Authors

John M Tarazi¹, Theofanis P Zois², Andrew Bohm², Michael A Mont³, Giles R Scuderi⁴

Affiliations

¹ Department of Orthopaedics, Northwell Health-Huntington Hospital, 270 Park Avenue, Huntington, NY, 11743, USA; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Boulevard, Hempstead, NY, 11549, USA.
² Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, 130 East 77th Street, 11th Floor, Black Hall, New York, NY, 10075, USA.
³ Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, 130 East 77th Street, 11th Floor, Black Hall, New York, NY, 10075, USA; Rubin Institute of Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD, 21215, USA. Electronic address: Rhondamont@aol.com.
⁴ Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra Boulevard, Hempstead, NY, 11549, USA; Department of Orthopaedics, Northwell Health-Lenox Hill Hospital, 130 East 77th Street, 11th Floor, Black Hall, New York, NY, 10075, USA.

PMID: 35365258
DOI: 10.1016/j.ocl.2021.12.001

Abstract

The purpose of this study was to determine if elevated pre-operative D-dimer levels in patients undergoing revision total knee arthroplasty (rTKA) pose an increased risk of: (1) post-operative venous thromboemboli (VTE); (2) intra-operative blood loss; and (3) need for transfusion of blood products. Eighty-nine patients who underwent rTKA by a single surgeon between January 1, 2017, and December 31, 2019, met the inclusion criteria. Elevated pre-operative D-dimer levels did not pose an increased risk of VTE, blood loss, or transfusion of blood products, demonstrating that elevated pre-operative D-dimer is not a contraindication to the use of tranexamic acid for rTKA.

Keywords: D-dimer; Revision total knee arthroplasty; TXA; Tranexamic acid; rTKA.

Publication types

Review

MeSH terms

Antifibrinolytic Agents* / therapeutic use
Arthroplasty, Replacement, Knee* / adverse effects
Fibrin Fibrinogen Degradation Products
Humans
Tranexamic Acid* / therapeutic use

Substances

Antifibrinolytic Agents
Fibrin Fibrinogen Degradation Products
fibrin fragment D
Tranexamic Acid