medigraphic.com
ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2021, Number 6

<< Back Next >>

Acta Ortop Mex 2021; 35 (6)

Applications of tranexamic acid in Orthopaedics and Traumatology

Berebichez-Fridman R, Castillo-Vázquez F, Berebichez-Fastlicht E

Language: Spanish
References: 43
Page: 539-546
PDF size: 212.91 Kb.


ABSTRACT

Introduction: Tranexamic acid is an antifibrinolytic drug which has been used in many disciplines of Medicine, as well as in Orthopaedics and Traumatology, with the objective of diminishing and preventing blood loss and the necessity of allogenic blood transfusion. This study has the objective to demonstrate the uses, indications and contraindications of tranexamic acid in the different subspecialties of Orthopaedics and Traumatology. Material and methods: A through search was performed looking at the most recent evidence regarding the use of tranexamic acid in the different subspecialties of Orthopaedics and Traumatology, as well as its indications, contraindications and adverse effects. Results: Tranexamic acid has a great amount of applications in Orthopaedics and Traumatology, especially in primary and revision knee and hip arthroplasties, spine surgery and trauma. It has been observed that tranexamic acid is effective in diminishing perioperative bleeding, less necessity of blood transfusion, among other benefits. Tranexamic acid is a safe drug, which does not increase the risk of developing thrombotic events in healthy patients. There are a number of administration routes of tranexamic acid as well as many dosage regimens, all being efficient. Therefore, no standardization regarding the best administration route and most effective dose has been established. Conclusions: Tranexamic acid is a safe and effective drug for diminishing perioperative bleeding and to avoid the necessity of blood transfusion, with many applications in Orthopaedics and Traumatology.


REFERENCES

  1. Jennings JD, Solarz MK, Haydel C. Application of tranexamic acid in trauma and orthopedic surgery. Orthop Clin North Am. 2016; 47: 137-43.

  2. Eubanks JD. Antifibrinolytics in major orthopaedic surgery. J Am Acad Orthop Surg. 2010; 18: 132-8.

  3. Mannucci PM. Hemostatic drugs. N Engl J Med. 1998; 339(4): 245-53.

  4. Melvin JS, Stryker LS, Sierra RJ. Tranexamic acid in hip and knee arthroplasty. J Am Acad Orthop Surg. 2015; 23(12): 732-40.

  5. Hunt BJ. The current place of tranexamic acid in the management of bleeding. Anaesthesia. 2015; 70(Suppl 1): 50-3.

  6. Ramirez RJ, Spinella PC, Bochicchio GV. Tranexamic acid update in trauma. Crit Care Clin. 2017; 33(1): 85-99.

  7. Bible JE, Mirza M, Knaub MA. Blood-loss management in spine surgery. J Am Acad Orthop Surg. 2018; 26(2): 35-44.

  8. Lin ZX, Woolf SK. Safety, efficacy, and cost-effectiveness of tranexamic acid in orthopedic surgery. Orthopedics. 2016; 39(2): 119-30.

  9. Liu X, Liu J, Sun G. A comparison of combined intravenous and topical administration of tranexamic acid with intravenous tranexamic acid alone for blood loss reduction after total hip arthroplasty: a meta-analysis. Int J Surg. 2017; 41: 34-43.

  10. Zeng Y, Si H, Shen B, Yang J, Zhou Z, Kang P, et al. Intravenous combined with topical administration of tranexamic acid in primary total hip arthroplasty: a randomized controlled trial. Orthop Surg. 2017; 9(2): 174-9.

  11. Fillingham YA, Ramkumar DB, Jevsevar DS, Yates AJ, Bini SA, Clarke HD, et al. Tranexamic acid use in total joint arthroplasty: the clinical practice guidelines endorsed by the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. J Arthroplasty. 2018; 33(10): 3065-9.

  12. Fillingham YA, Ramkumar DB, Jevsevar DS, Yates AJ, Shores P, Mullen K, et al. The efficacy of tranexamic acid in total knee arthroplasty: a network meta-analysis. J Arthroplasty. 2018; 33(10): 3090-3098.

  13. García-Dobarganes-Barlow F, Romo-Aguilera IJ, Negrete-Corona J, Guevara-Álvarez A, Garcini-Munguía F, Téllez-Hoyos S. Eficacia del ácido tranexámico para la disminución de la transfusión de sangre alogénica en la artroplastía total de cadera. Acta Ortop Mex. 2020; 34(1): 6-9.

  14. Yamasaki S, Masuhara K, Fuji T. Tranexamic acid reduces postoperative blood loss in cementless total hip arthroplasty. J Bone Joint Surg Am. 2005; 87: 766-70.

  15. Sukeik M, Alshryda S, Haddad FS, Mason JM. Systematic review and meta-analysis of the use of tranexamic acid in total hip replacement. J Bone Joint Surg Br. 2011; 93(1): 39-46.

  16. Peck J, Kepecs DM, Mei B, Safir OA, Backstein D, Gross AE, et al. The effect of preoperative administration of intravenous tranexamic acid during revision hip arthroplasty. J Bone Joint Surg Am. 2018; 100(17): 1509-16.

  17. Kayupov E, Fillingham YA, Okroj K, Plummer DR, Moric M, Gerlinger TL, et al. Oral and intravenous tranexamic acid are equivalent at reducing blood loss following total hip arthroplasty. J Bone Joint Surg Am. 2017; 99(5): 373-8.

  18. Farrow LS, Smith TO, Ashcroft GP, Myint P. A systematic review of tranexamic acid in hip fracture surgery. Br J Clin Pharmacol. 2016; 82(6): 1458-70.

  19. Levine BR, Haughom B, Strong B, Hellman M, Frank RM. Blood management strategies for total knee arthroplasty. J Am Acad Orthop Surg. 2014; 22(6): 361-71.

  20. Abdel MP, Chalmers BP, Taunton MJ, Pagnano MW, Trousdale RT, Sierra RJ, et al. Intravenous versus topical tranexamic acid in total knee arthroplasty. J Bone Jt Surg. 2018; 100(12): 1023-9.

  21. Yang Z-G, Chen W-P, Wu L-D. Effectiveness and safety of tranexamic acid in reducing blood loss in total knee arthroplasty: a meta-analysis. J Bone Jt Surg. 2012; 94(13): 1153-9.

  22. Alshryda S, Sarda P, Sukeik M, Nargol A, Blenkinsopp J, Mason JM. Tranexamic acid in total knee replacement: a systematic review and meta-analysis. J Bone Joint Surg Br. 2011; 93(12): 1577-85.

  23. Boese CK, Centeno L, Walters RW. Blood conservation using tranexamic acid is not superior to epsilon-aminocaproic acid after total knee arthroplasty. J Bone Jt Surg. 2017; 99(19): 1621-8.

  24. Huang Z, Xie X, Li L, Huang Q, Ma J, Shen B, et al. Intravenous and topical tranexamic acid alone are superior to tourniquet use for primary total knee arthroplasty. J Bone Joint Surg Am. 2017; 99(24): 2053-61.

  25. Schnettler T, Papillon N, Rees H. Use of a tourniquet in total knee arthroplasty causes a paradoxical increase in total blood loss. J Bone Joint Surg Am. 2017; 99(16): 1331-6.

  26. Gomez-Barrena E, Ortega-Andreu M, Padilla-Eguiluz NG, Pérez-Chrzanowska H, Figueredo-Zalve R. Topical intra-articular compared with intravenous tranexamic acid to reduce blood loss in primary total knee replacement. J Bone Joint Surg Am. 2014; 96(23): 1937-44.

  27. Dobarganes-Barlow F, López-Villers A, Trueba-Vasavilbaso C, Navarrete-Álvarez J, Rebuelta-Cancio A, Garcini-Munguia F, et al. Uso de ácido tranexámico en la artroplastía total primaria de rodilla. Acta Ortop Mex. 2019; 33(6): 352-6.

  28. Klement MR, Padua FG, Li WT, Detweiler M, Parvizi J. Tranexamic acid reduces the rate of periprosthetic joint infection after aseptic revision arthroplasty. J Bone Joint Surg Am. 2020; 102(15): 1344-50.

  29. Cheriyan T, Maier SP 2nd, Bianco K, Slobodyanyuk K, Rattenni RN, Lafage V, et al. Efficacy of tranexamic acid on surgical bleeding in spine surgery: a meta-analysis. Spine J. 2015; 15(4): 752-61.

  30. Yang B, Li H, Wang D, He X, Zhang C, Yang P. Systematic review and meta-analysis of perioperative intravenous tranexamic acid use in spinal surgery. PLoS One. 2013; 8(2): e55436.

  31. Tsutsumimoto T, Shimogata M, Ohta H, Yui M, Yoda I, Misawa H. Tranexamic acid reduces perioperative blood loss in cervical laminoplasty: a prospective randomized study. Spine. 2011; 36(23): 1913-1918.

  32. Pong RP, Leveque J-CA, Edwards A, Yanamadala V, Wright AK, Herodes M, et al. Effect of tranexamic acid on blood loss, D-dimer, and fibrinogen kinetics in adult spinal deformity surgery. J Bone Jointt Surg Am. 2018; 100(9): 758-64.

  33. Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y, El-Sayed H, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomized, placebo-controlled trial. Lancet. 2010; 376(9734): 23-32.

  34. Roberts I, Shakur H, Coats T, Hunt B, Balogun E, Barnetson L, et al. The CRASH-2 trial: a randomized controlled trial and economic evaluation of the effects of tranexamic acid on death, vascular occlusive events and transfusion requirement in bleeding trauma patients. Health Technol Assess. 2013; 17(10): 1-79.

  35. Morrison JJ, Dubose JJ, Rasmussen TE, Midwinter MJ. Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study. Arch Surg. 2012; 147(2): 113-9.

  36. Gausden EB, Qudsi R, Boone MD, Gara BO, Ruzbarsky JJ, Lorich DG. Tranexamic acid in orthopaedic trauma surgery: a meta-analysis. J Orthop Trauma. 2017; 31(10): 513-9.

  37. Poeran J, Rasul R, Suzuki S, Danninger T, Mazumdar M, Opperer M, et al. Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: retrospective analysis of effectiveness and safety. BMJ. 2014; 349: g4829.

  38. Hallstrom B, Singal B, Cowen ME, Roberts KC, Hughes RE. The Michigan experience with safety and effectiveness of tranexamic acid use in hip and knee arthroplasty. J Bone Joint Surg Am. 2016; 98(19): 1646-55.

  39. Ralley FE. Tranexamic acid: When is enough (data) enough? Can J Anaesth. 2015; 62(11): 1149-52.

  40. Aguilera-Roig X, Jordán-Sales M, Natera-Cisneros L, Monllau-García JC, Martínez-Zapata M. Ácido tranexámico en cirugía ortopédica. Rev Esp Cir Ortop Traumatol. 2014; 58(1): 52-6.

  41. Danninger T, Memtsoudis SG. Tranexamic acid and orthopedic surgery - the search for the holy grail of blood conservation. Ann Transl Med. 2015; 3(6): 77-80.

  42. Dastrup A, Anton P, Hallas J, Overgaard S. Perioperative tranexamic acid treatment and risk of cardiovascular events or death after total hip arthroplasty. J Bone Joint Surg Am. 2018; 100(20): 1742-9.

  43. Ng W, Jerath A, Wasowicz M. Tranexamic acid: a clinical review. Anesthesiol Intensive Ther. 2015; 47(4): 339-50.



EVIDENCE LEVEL

III




2020     |     www.medigraphic.com