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Epsilon Aminocaproic Acid (EACA) and Tranexamic Acid (TXA) in Total Knee Arthroplasty (TKA) - A Prospective Randomized Trial

Epsilon Aminocaproic Acid (EACA) and Tranexamic Acid (TXA) in Total Knee Arthroplasty (TKA) - A Prospective Randomized Trial

João P.F. Guerreiro, MD, PhD, BRAZIL João P.F. Guerreiro, MD, PhD, BRAZIL Jose Rodolfo Martines Balbino, MD, BRAZIL Bruno Possani Rodrigues, MD, BRAZIL Marcus Vinicius Danieli, MD, PhD, BRAZIL Daniele Cristina Cataneo, MD, PhD, BRAZIL

Uniort.e Londrina/Unesp Botucatu/Londrina Evangelic Hospital, Londrina, Parana, BRAZIL


2021 Congress   ePoster Presentation     Not yet rated

 

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Summary: The primary aim was to examine and compare the clinical efficacy of topical EACA and TXA following TKA. This study was a prospective, single-centre, double-blinded randomized controlled trial with 60 patients. The Hgb values, Htb values, knee flexion and WOMAC questionnaire scores were statistically equal among the two groups in the preoperative period.


Purpose

The primary aim was to examine and compare the clinical efficacy of topical EACA and TXA following TKA. The study questions were whether EACA and TXA were similar with regard to blood conservation, postoperative pain control, postoperative gain in knee flexion and function.

Methods

This study was a prospective, single-centre, double-blinded randomized controlled trial. Sixty patients with osteoarthritis of the knee were included. After a randomization the participants was divided into 2 groups of 30 patients. In the TXA group, was applied 1 g of TXA (0,05 g/ml) intraarticular and in the EACA group were applied 4 g of EACA (0.2 g/ml) intraarticular. Serum Hgb and Htb were measured in the preoperative period and 24 and 48 hours after surgery. The range of motion, pain and wounds were evaluated by clinical examination. The Western Ontario and McMaster Universities Index (WOMAC) questionnaire was used to evaluate knee function before surgery and 2 months after surgery.

Results

A total of 56 (93,3%) patients were evaluated up to the 2nd postoperative month after surgery. The Hgb values, Htb values, knee flexion and WOMAC questionnaire scores were statistically equal among the two groups in the preoperative period

Conclusion

The drop in Hgb and Htb levels in the first 48-hour postoperative period and the risk of transfusion were similar intraarticular use of 1 g TXA or 4 g EACA at the end of TKA. The possible benefits in pain control, flexion gain and knee function were also similar between the two drugs.