Abstract
The purpose of this study was to investigate the efficacy of tranexamic acid (TXA) in patients undergoing open-wedge high tibial osteotomy (OWHTO). Patients from August 2018 to May 2020 were retrospectively studied. Clinical data were obtained including gender, age, height, weight, body mass index (BMI), smoking, alcohol consumption, hypertension, diabetes, history of aspirin, prepostoperative hematocrit (Hct) and hemoglobin (Hb), thrombotic events, blood transfusion requirement, hospital length of stay, size of osteotomy gap, and wound complications such as wound hematoma and infection. 52 patients were enrolled in the tranexamic acid group (TA group), and 48 patients were enrolled in the nontranexamic acid group (NTA group); there were no significant differences between both groups in terms of gender, age, BMI, preoperative Hb, size of osteotomy gap, incidence of smoking, alcohol consumption, hypertension, diabetes, history of aspirin, thrombotic events, blood transfusion requirement, and wound hematoma and infection. The mean hospital length of stay was 9.4 ± 1.0 days in the TA group and 11.0 ± 1.2 days in the NTA group (P < 0.001), the blood loss was 296.0 ± 128.7 ml in the TA group and 383.3 ± 181.3 ml in the NTA group (P < 0.05), and the postoperative Hb level was 120.8 ± 15.0 g/l in the TA group and 109.5 ± 13.8 g/l in the NTA group (P < 0.001). In conclusion, the administration of TXA is beneficial to patients undergoing OWHTO via decreasing hospital length of stay, reducing blood loss, and maintaining higher postoperative Hb levels.
Highlights
Knee osteoarthritis (OA) is characterized by articular cartilage lesions and underlying bone destruction [1,2,3,4]
A large retrospective cohort study involving over 800000 patients undergoing total hip or knee arthroplasty revealed that the demand for allogeneic or autologous blood transfusions was decreased by up to 69% in the tranexamic acid group [26]
Our previous study revealed that alcohol consumption and body mass index (BMI) are important risk factors related to blood loss in Open-wedge high tibial osteotomy (OWHTO) [27]; there is less research on the effects of tranexamic acid (TXA) in patients’ blood management about OWHTO
Summary
Knee osteoarthritis (OA) is characterized by articular cartilage lesions and underlying bone destruction [1,2,3,4]. Open-wedge high tibial osteotomy (OWHTO) is a reliable option for knee osteoarthritis with varus malalignment in young, active people [8,9,10,11]. This technique is easy to learn and allows precise correction during the surgical procedure; it creates an osteotomy gap and increases the risk of bleeding theoretically [12,13,14]. A large retrospective cohort study involving over 800000 patients undergoing total hip or knee arthroplasty revealed that the demand for allogeneic or autologous blood transfusions was decreased by up to 69% in the tranexamic acid group [26]. The purpose of this study was to investigate the efficacy of TXA in patients undergoing OWHTO
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