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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Tranexamic acid,Blood loss,intravenous,Topical,Total knee arthroplasty
- چکیده:
- چکیده انگلیسی: Background: Blood loss during and immediately after total knee arthroplasty (TKA) is among the most challenging
concerns. It has been demonstrated that Tranexamic acid (TXA) can help to reduce perioperative blood loss. TXA
can be used as an oral, topical or intravenous injection. Many studies evaluated the effectiveness of each route of
administration but few works on a comparison between them. The current study aimed to compare the effectiveness
of intravenous injection versus topical use of TXA in reducing perioperative blood loss after primary total knee
arthroplasty.
Methods: Eighty-five patients who were a candidate for total knee arthroplasty were randomized into two groups:
one group received Intravenous injection of 15 mg/kg TXA, 10 min before tourniquet inflation while the other group
received 1 g diluted TXA during wound closure. The postoperative blood loss was estimated by measuring the
whole drain output and also hemoglobin (HB) drops. Both groups compared based on the need for allogenic blood
transfusion and also thromboembolic events.
Results: Patients who received topical TXA had a higher total drain output (P<0.0001) compared to intravenous
injection. The hemoglobin drop also was more in the topical group although it was marginally significant (P=0.05).
Conclusion: Intravenous injection of TXA is more effective in reducing postoperative blood loss after primary TKA
compared to topical administration.
Level of evidence: I- انتشار مقاله: 25-03-1398
- نویسندگان: Ali Torkaman,Amir Rostami,Mohammad Reza Sarshar,Hamidreza Yazdi,Hossein Akbari Aghdam,Paniz Motaghi
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Nerve injury,ACL reconstruction,Hamstring graft harvest,Infrapatellar branch of saphenous nerve,Saphenous nerve
- چکیده:
- چکیده انگلیسی: Background: Injury to the infrapatellar branch of the saphenous nerve (IPBSN) is common after arthroscopic ACL
reconstruction with hamstring tendon autograft, as reported in up to 88% of the cases. Due to close relationship
between the IPBSN with pes anserine tendons insertion skin incision may sever IPBSN while harvesting gracillis and
semitendinous tendons. As the IPBSN course at the anterior of knee is oblique, we hypothesized a parallel skin incision
with nerve passage may decrease nerve injury.
Methods: Vertical and oblique incisions were compared in 79 patients in this clinical trial. The sensory loss area and
patients’ complain of numbness were measured at 2 and 8 weeks as well as 6 months after surgery.
Results: Both the sensory loss area and patients’ complain of numbness decreased significantly in the oblique incision
group (P<0001).
Conclusion: According to our findings, oblique incision is suggested instead of traditional vertical incision when
hamstring tendons are being harvested in arthroscopic ACL reconstruction with hamstring tendon autograft.
Level of evidence: IV- انتشار مقاله: 10-10-1395
- نویسندگان: Hamid Mousavi,Mohammad Mohammadi,Hossein Akbari Aghdam
- مشاهده