Peri-articular Tranexamic Acid Injection in Total Knee Arthroplasty

July 11, 2016 updated by: piya pinsornsak, Thammasat University

Peri-articular Tranexamic Acid Injection in Total Knee Arthroplasty: A Randomized Controlled Trial

This study evaluates the peri-articular tranexamic acid injection in total knee arthroplasty which is an alternative route of administration for blood loss reduction. Half of participants will receive intravenous tranexamic acid injection, while the other half will receive peri-articular tranexamic acid injection during total knee arthroplasty.

Study Overview

Detailed Description

Intravenous tranexamic acid (IV TXA) is one of the most effective agents in use for reducing blood loss following total knee arthroplasty (TKA) but its safety regarding venous thromboembolic events (VTEs) remains in question. The direct, local application of TXA may reduce systemic toxicity whilst maintaining good or better bleeding control compared to IV TXA. The topical application of TXA via Hemovac drains has been reported previously with good results. However, there are no data on peri-articular TXA injections during TKA.

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Phase 2

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Pathumthani
      • Klongluang, Pathumthani, Thailand, 12120
        • Orthopaedic department, Thammasat university hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • adult patients with osteoarthritis in need of a TKA

Exclusion Criteria:

  • inflammatory arthritis
  • post-traumatic arthritis
  • a history of or current venous thromboembolic disease
  • any underlying disease of haemostasis
  • cirrhosis
  • chronic renal failure
  • patients on anticoagulants or strong antiplatelet drugs (e.g. warfarin, clopidogrel)
  • know allergy to TXA
  • defective color vision
  • preoperative hemoglobin <10 g/dL
  • platelet count < 140,000 /uL3

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Peri-articular group
Patients received 750 mg of peri-articular Tranexamic acid (Transamin®; OLIC Thailand Ltd, Bangkok, Thailand; 250 mg/5 mL, 15 cc total volume) injection into the soft tissue around medial capsule (5 ml), lateral capsule (5 ml) and around the quadriceps muscle (5 ml), 10 minutes prior to deflating the tourniquet and wound closure.
750 mg of peri-articular TXA, prior to deflating the tourniquet and wound closure
Other Names:
  • Transamin
Active Comparator: Intravenous group
Patients received 750 mg of intravenous tranexamic acid(250 mg/5 ml, 15 cc total volume, keeping within the therapeutic range of 10-15 mg/kg/dose), 10 minutes prior to deflating the tourniquet and wound closure.
750 mg of IV TXA, prior to deflating the tourniquet and wound closure
Other Names:
  • Transamin

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
The volume of postoperative blood loss in the drain
Time Frame: 48 hours after the operation
48 hours after the operation
Changes from baseline hemoglobin concentrations
Time Frame: 48 hours after the operation
48 hours after the operation
unit of blood transfusion
Time Frame: 48 hours after the operation
48 hours after the operation

Secondary Outcome Measures

Outcome Measure
Time Frame
Knee diameter for swelling
Time Frame: At 24 and 48 hours after the operation
At 24 and 48 hours after the operation
number of patient with venous thromboembolism
Time Frame: At 14 days after the operation
At 14 days after the operation

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Piya Pinsornsak, MD, Faculty of Medicine, Thammasat university

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2012

Primary Completion (Actual)

October 1, 2013

Study Completion (Actual)

October 1, 2013

Study Registration Dates

First Submitted

July 5, 2016

First Submitted That Met QC Criteria

July 11, 2016

First Posted (Estimate)

July 12, 2016

Study Record Updates

Last Update Posted (Estimate)

July 12, 2016

Last Update Submitted That Met QC Criteria

July 11, 2016

Last Verified

July 1, 2016

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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