Dose tranexamic acid reduce blood loss associated with simultaneous bilateral distal tibial tubercle-high tibial osteotomy?

BMC Musculoskelet Disord. 2021 Nov 10;22(1):940. doi: 10.1186/s12891-021-04831-3.

Abstract

Background: Simultaneous bilateral distal tibial tubercle high tibial osteotomy (SBDTT-HTO) can result in increased blood loss. The aim of this study is to evaluate the actual hemostatic effect of different tranexamic acid (TXA) treatment regimen in SBDTT-HTO.

Methods: We conducted a retrospective case-control study including 54 patients who underwent SBDTT-HTO. The single-dose group (n = 18) received 1 g of intravenous TXA 15-30 min before surgery, the two-dose group (n = 18) received an additional 1 g of intravenous TXA 6 h after surgery, and the multiple-dose group (n = 18) received an additional 1 g intravenous TXA per-day until discharge. Blood loss, hemoglobin levels, occurrence of any adverse events,functional analysis, quality of life, and pain assessmentswere compared among the three groups.

Results: The total blood loss, hidden blood loss, drainage volumes, and haemoglobin level in the multiple-dose group all occupy a significant advantage.(p < 0.05). In addition, better quality of life were observed in patients belonging to the multiple-dose group then single-dose group.(p < 0.05).

Conclusions: Based on our results, for patients undergoing SBDTT-HTO, sequential intravenous TXA administration can effectively and safely reduce blood loss,maintain postoperative Hb levels,and with the advantage of accelerating recovery.

Keywords: Blood loss; High tibial osteotomy; Simultaneous bilateral; Tranexamic acid.

MeSH terms

  • Administration, Intravenous
  • Antifibrinolytic Agents* / therapeutic use
  • Blood Loss, Surgical / prevention & control
  • Case-Control Studies
  • Humans
  • Osteotomy
  • Postoperative Hemorrhage / prevention & control
  • Quality of Life
  • Retrospective Studies
  • Tranexamic Acid*

Substances

  • Antifibrinolytic Agents
  • Tranexamic Acid