Temporary Clamping of Drains Combined With Tranexamic Acid Reduce Blood Loss After TKA: A Prospective RCT
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Purpose
Total knee arthroplasty (TKA) may be associated with significant blood loss, and transfusion carries substantial risk of immunologic reaction and disease transmission. Several methods reportedly reduce postoperative blood loss and avoid homologous blood transfusion with traditional TKA approaches. Drain clamping was one of the widely used method and tranexamic acid administration was the recently adjuvant method to reduce blood loss in TKA. However, there were several regimens in either drain clamping or tranexamic acid administration reported in previous studies. Our objective was to compare the efficacy of our drain clamping protocol and/or tranexamic acid regimen for reducing blood loss and transfusion in TKA.
| Condition | Intervention |
|---|---|
|
Osteoarthritis of Knee |
Drug: Tranexamic acid Procedure: Drain clamping Other: Drain clamping and tranexamic acid Other: No clamp and placebo |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Prevention |
| Official Title: | Temporary Clamping of Drains Combined With Tranexamic Acid Reduce Blood Loss After Total Knee Arthroplasty: A Prospective Randomized Controlled Trial. |
- Postoperative blood loss [ Time Frame: 48 hours after operation ] [ Designated as safety issue: Yes ]
- Number of blood transfusion [ Time Frame: 5 days ] [ Designated as safety issue: Yes ]
| Enrollment: | 240 |
| Study Start Date: | June 2008 |
| Study Completion Date: | November 2008 |
| Primary Completion Date: | June 2008 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Group A
No clamp and placebo
|
Other: No clamp and placebo
The drain was not clamped. The patient received placebo (saline 10 minutes before surgery and three hours post-operative, and then an oral form of placebo 2X3 capsules for five days).
|
|
Experimental: Group B
Tranexamic acid
|
Drug: Tranexamic acid
the drain was not clamped and the patient received tranexamic acid 10mg/kg intravenous 10 minutes before inflating the tourniquet and 10mg/kg intravenous three hours post-operative, and then tranexamic acid 250mg/capsule 2X3 orally for five days.
|
|
Experimental: Group C
Drain clamping
|
Procedure: Drain clamping
the drain was clamped for three hours, released for three hours, then clamped for another three hours, and then released free for 48 hours. The patient received placebo (saline 10 minutes before surgery and three hours post-operative, and then an oral form of placebo 2X3 capsules for five days).
|
|
Experimental: Group D
Drain clamping and tranexamic acid
|
Other: Drain clamping and tranexamic acid
the drain was clamped for three hours, released for three hours, then clamped for another three hours, and then released free for 48 hours. the patient received tranexamic acid 10mg/kg intravenous 10 minutes before inflating the tourniquet and 10mg/kg intravenous three hours post-operative, and then tranexamic acid 250mg/capsule 2X3 orally for five days.
|
Eligibility| Ages Eligible for Study: | 40 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- The patients younger than 85 years with knee osteoarthritis
Exclusion Criteria:
- The patient diagnosed secondary osteoarthritis (eg, rheumatoid arthritis, posttraumatic arthritis, gouty arthritis, postseptic arthritis)
- High-risk medical comorbid patient
- The patient who was planed for simultaneous bilateral TKAs
- The patient who had history of thromboembolic disease or bleeding disorder
- The patient who was receiving anticoagulant drug treatment
- The patient who had allergy to tranexamic acid
Contacts and Locations
More Information
No publications provided by Mahidol University
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Keerati Charoencholvanich, Associate Professor, Mahidol University |
| ClinicalTrials.gov Identifier: | NCT01449552 History of Changes |
| Other Study ID Numbers: | Si463/2007 |
| Study First Received: | October 5, 2011 |
| Last Updated: | November 4, 2011 |
| Health Authority: | Thailand: Ethical Committee |
Additional relevant MeSH terms:
|
Osteoarthritis Osteoarthritis, Knee Arthritis Joint Diseases Musculoskeletal Diseases Rheumatic Diseases Tranexamic Acid Antifibrinolytic Agents |
Fibrin Modulating Agents Molecular Mechanisms of Pharmacological Action Pharmacologic Actions Hemostatics Coagulants Hematologic Agents Therapeutic Uses |
ClinicalTrials.gov processed this record on May 19, 2013