Abstract：
BACKGROUND:The antifibrinolytic tranexamic acid reduces surgical blood loss, but studies have not identified an optimal regimen. QUESTIONS/PURPOSES:We studied different dosages, timings, and modes of administration to identify the most effective regimen of tranexamic acid in achieving maximum reduction of blood loss in TKA. METHODS:We prospectively studied five regimens (four intravenous, one local; 40 patients each) with a control group (no tranexamic acid). The four intravenous (10-mg/kg dose) regimens included (1) intraoperative dose (IO) given before tourniquet deflation, (2) additional preoperative dose (POIO), (3) additional postoperative dose (IOPO), and (4) all three doses (POIOPO). The fifth regimen was a single local application (LA). Two independent parameters of drain loss and total blood loss, calculated by the hemoglobin balance method, were evaluated statistically. RESULTS:Both parameters were reduced in all five regimens as against the control. A significant reduction in drain loss was seen in the POIO, IOPO, and POIOPO groups whereas total blood loss was significantly reduced in the POIO, POIOPO, and LA groups. The POIOPO group had the least drain loss (303 mL) and least total blood loss (688 mL). The IO group had the greatest drain loss and the IOPO group the greatest total blood loss. CONCLUSIONS:Single-dose tranexamic acid did not give effective results. The two-dose regimen of POIO was the least amount necessary for effective results. When compared against the control, this regimen produced reduction of drain loss and total blood loss, whereas the IOPO regimen did not. The three-dose regimen of POIOPO produced maximum effective reduction of drain loss and total blood loss.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Maniar RN,Kumar G,Singhi T,Nayak RM,Maniar PRdoi
10.1007/s11999-012-2310-ysubject
Has Abstractpub_date
2012-09-01 00:00:00pages
2605-12issue
9eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章,随机对照试验abstract：:A study of 281 patients evaluated for a meniscus pathologic condition was performed to assess the accuracy of the clinical diagnosis and arthrogram and delineate the role of arthroscopy. Following the clinical examination, the surgeon stated his level of confidence in his diagnosis, as did the radiologist in his inter...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-03-01 00:00:00
abstract：:This study examines effects of acute stretch on electrophysiologic properties of rabbit tibial nerve. Compound motor action potentials (CMAP) were measured in 30 rabbits, during and after two hours of acute, graded strain. The rabbits were assigned to one of three groups defined by the degree of stretch (0%, 8%, or 15...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-11-01 00:00:00
abstract：:A prospective randomized study undertaken in 30 patients who underwent outpatient decompressive acromioplasty demonstrated the efficacy and safety of interscalene block post-operatively. Interscalene block improved the postoperative condition and well being of these patients. Their use decreased the hospitalization ra...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1994-07-01 00:00:00
abstract：:A heterogeneous group of 17 patients with aseptic necrosis of the femoral head had treatment of 23 hips by bone grafting. Phemister-type tibial grafts were used in 20 and iliac grafts in 3. All hips were evaluated before and after grafting according to roentgenographic stage of disease and the Hospital for Special Sur...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199808000-00028
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abstract：:If the underlying pathology of the syndrome of fat embolism is the presence of circulating emboli of neutral fat with adherent platelets and red blood cells, then one could expect certain changes in normal vascular cellular elements and fat metabolism, with resultant alterations in pulmonary function. In our series of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-03-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2004-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11999.0000000000000112
更新日期：2018-02-01 00:00:00
abstract：UNLABELLED:Recently, medial patellofemoral ligament reconstruction has been emphasized for the treatment of patellar dislocation. This study compared the results of medial patellofemoral ligament reconstruction by adductor magnus tenodesis with distal patellar realignment in patients with recurrent patellar dislocation...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0207-6
更新日期：2008-06-01 00:00:00
abstract：:Congenital pseudarthrosis of the tibia presents surgeons with one of the most challenging of all orthopedic problems. The results of various forms of surgical treatment are rarely successful. This is a preliminary report on an implanted direct current bone growth stimulator (DCBGS) for treatment of congential pseudart...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-10-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-06-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000201152.98830.ed
更新日期：2006-03-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-03-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000069885.72909.bb
更新日期：2003-06-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-09-01 00:00:00
abstract：:Arthrographic study of the knee was performed in six patients for diagnosis of acute rupture of the quadriceps tendon. All of the patients gave a history of attempting to recover from a fall. Pain and tenderness over the suprapatellar area were common findings in all patients. Four patients had a positive arthrogram d...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1982-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
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更新日期：1991-09-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000218747.92118.3a
更新日期：2006-06-01 00:00:00
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
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更新日期：2006-11-01 00:00:00
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journal_title：Clinical orthopaedics and related research
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journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-05-01 00:00:00
abstract：:Recombinant human bone morphogenetic protein-2 is an osteoinductive protein that plays a pivotal role in bone growth and regeneration. Several hundred studies were conducted in the past 7 years in numerous animal models to establish unequivocally the efficacy, safety, mechanism of action, pharmacokinetics, and surgica...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200202000-00011
更新日期：2002-02-01 00:00:00
