2017 ISAKOS Biennial Congress ePoster #1012

 

Intra-Articular Injection of Tranexamic Acid for Reducing Post-Operative Hemarthrosis in Arthroscopic Anterior Cruciate Ligament Reconstruction

En-Rung Chiang, MD, Taipei TAIWAN
Hsiao-Li Ma, MD, Taipei, Taiwan TAIWAN

Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, TAIWAN

FDA Status Cleared

Summary

Intra-articular Injection of Tranexamic Acid is Effective for Decreasing Post-operative Hemarthrosis in Arthroscopic Anterior Cruciate Ligament Reconstruction

Abstract

Post-anterior cruciate ligament (ACL) reconstruction hemarthrosis may result in increased pain and delayed post-operative rehabilitation, which may eventually lead to arthrofibrosis and functional deficit. Many antifibrinolytic agents, including tranexamic acid (TXA), had been used in orthopaedic surgeries to reduce post-operative bleeding. The purpose of this study is to evaluate the effect of intraarticular injection of TXA in patients receiving arthroscopic ACL reconstructions. Between June 2014 and February 2015, 300 patients were enrolled in this study. Single bundle reconstructions using autologous hamstring tendon graft were performed in all patients. Patients were randomized into two groups: group 1 patients (TXA group, n= 151) received the index procedures with intraarticular injection of 10 ml TXA. Group 2 (control group, n=149) patients received the procedures only without injections. An intra-articular suction drain was placed in the joint and clamped for 2 hours after the procedure. The volume of drainage was recorded 24 hours postoperatively. Clinical evaluation using IKDC and KOOS scores was performed at postoperative day 5 and 4 weeks. Post-operatively, significant reduced drainage amount in patients receiving intraarticular injections were observed (TXA group: 56.1±34.1ml; control group: 80.1±48 ml, p<0.05) At day 5, reduced pain scores were reported in TXA group patients. However, after 4 weeks, clinical function scores did not show significant difference between two groups. The results of this prospective, randomized study demonstrated that TXA has the effect of reducing the post-operative intraarticular bleeding in first 24 hours in arthroscopic ACL reconstruction. Decreased knee pain was also noted in the early post-operative period of the procedure. Significant beneficial clinical effects were not evident after 4 weeks of operation.