Efficacy of intravenous tranexamic acid administration in medial opening wedge distal tuberosity osteotomy (MOWDTO) for varus knee osteoarthritis: a randomized control trial

Abstract

Abstract Background: This randomized controlled study was undertaken to investigate the efficacy of intravenous tranexamic acid (TXA) administration in reducing perioperative blood loss in patients undergoing medial open-wedge distal tibial tuberosity osteotomy (MOWDTO). It was hypothesized that TXA would reduce perioperative blood loss in MOWDTO. Methods: A total of 61 knees in 59 patients who underwent MOWDTO during the study period were randomly assigned to either of the groups with intravenous TXA administration (TXA group) or without TXA administration (Control group). In the TXA group, patients received 1000 mg of TXA intravenously before skin incision and 6 hours after the first dose. The primary outcomes was the volume of perioperative total blood loss which calculated using the blood volume and hemoglobin (Hb) drop. The Hb drop was calculated as the difference between preoperative Hb and postoperative Hb at day1,3,and 7. Results: The perioperative total blood loss was significantly lower in the TXA group (543±219 ml vs 880±268 ml, P < 0.001). The Hb drop were significantly lower at postoperative days 1, 3 and 7 in the TXA group than in the control group (Day 1: 1.28 ± 0.68 g/dl vs 1.91 ± 0.69 g/dl, P = 0.001; Day 3: 1.54 ± 0.66 g/dl vs 2.69 ± 1.00 g/dl, P < 0.001; Day 7: 1.74 ± 0.66 g/dl vs 2.83 ± 0.91 g/dl, P < 0.001). Conclusion: Intravenous TXA administration in MOWDTO could reduce the perioperative blood loss. Trial registration: The study was approved by the institutional review board. (Registered on 26/02/2019 Registration Number 3136). Level of Evidence: Level I, randomized controlled trial.