Abstract
BackgroundThe lower limb joints, including hip and knee, are the most commonly involved joints in haemophilic arthropathy. With a higher risk of transfusion, total hip and knee arthroplasty (THA and TKA) are still the first choice after failure of conservative treatment. In the present study, we aimed to analyze clinical outcomes and complications rate after total joint arthroplasty of the lower limbs using tranexamic acid (TXA) or not.MethodsThirty-four patients with haemophilia A undergoing 24 TKA and 18 THA were evaluated in this retrospective study (No. 201302009). Based on using TXA or not, they were divided into either TXA (12 knees and 10 hips) or Non-TXA groups (12 knees and 8 hips). Total blood loss, intraoperative blood loss, total amount of FVIII usage, range of motion, inflammatory biomarkers, joint function, pain status, complication rate and patient satisfaction were assessed and compared at a mean follow-up of 68 months.ResultsUsage of TXA can decrease not only the perioperative blood loss (p = 0.001), transfusion rate (p = 0.017) and supplemental amount of FVIII (p < 0.001) but also swelling ratio, surgical joint pain. Moreover, compared with non-TXA group, the patients in TXA group had a lower level of inflammatory biomarkers and better joint function.ConclusionThe hemophiliacs treated with TXA had less perioperative blood loss, hidden blood loss, transfusion rate, a lower ratio of postoperative knee swelling, less postoperative joint pain, lower levels of inflammatory biomarkers and better joint function. Further studies need performing to assess the long-term effects of TXA in these patients.
Highlights
The lower limb joints, including hip and knee, are the most commonly involved joints in haemophilic arthropathy
The most important finding of the present study was that usage of tranexamic acid (TXA) can decrease the perioperative blood loss, transfusion rate and supplemental amount of factor VIII (FVIII) and swelling ratio and surgical joint pain
Compared with non-TXA group, the patients in TXA group had a lower level of inflammatory biomarkers and better joint function
Summary
The lower limb joints, including hip and knee, are the most commonly involved joints in haemophilic arthropathy. With a higher risk of transfusion, total hip and knee arthroplasty (THA and TKA) are still the first choice after failure of conservative treatment. We aimed to analyze clinical outcomes and complications rate after total joint arthroplasty of the lower limbs using tranexamic acid (TXA) or not. The most commonly involved joints are the lower limb joints, such as hip and. It is widely acknowledged that perioperative blood loss is one of the major complications following lower extremity TJA [9,10,11]. Hemophiliacs would be more likely to have a higher perioperative blood loss as a consequence of a decrease of the intrinsic clotting ability.
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