Tranexamic Acid Combined with Compression Bandage Following Total Knee Arthroplasty Promotes Blood Coagulation: A Retrospective Analysis

Abstract

Objective. This paper included a retrospective review of the effect of tranexamic acid (TXA) combined with pressure bandaging on hemostasis of patients who received a unilateral total knee arthroplasty (TKA) from 2017 to 2019. Methods. A total of 197 patients undergoing TKA were chosen to be classified into 2 groups, the compression bandage control group and compression bandage combined with TXA observation group. The patients received blood routine examination when they were in the 1st, 3rd, and 6th days of before and postoperation. Some parameters, such as hemoglobin (Hb), C-reactive protein (CRP), D-dimer value, fibrinogen, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), international normalized ratio (INR), and erythrocyte sedimentation rate (ESR), were also investigated. Results. In our research, the mean age was $66.54\pm 7.95$ years. No difference was found in patient sex ( $P=0.876$ ) and age ( $P=0.749$ ) between groups. No differences were found in the levels of Hb, fibrinogen, TT, and INR between the 2 groups at each period ( $P>0.05$ ). The difference of PT was significantly different on the 1st day ( $P=0.011$ ), 3rd day ( $P=0.010$ ), and 6th day ( $P=0.004$ ) after surgery. Besides, the changes in APTT in observation group were clearly higher compared with the control group on the 3rd day ( $P=0.001$ ) and 6th day ( $P=0.001$ ). On the 3rd and 6th days after operation, the CRP level of the two groups increased continuously, and the CRP level was significantly higher in the observation group in comparison with the control group ( $P=0.008$ , $P=0.010$ ). On 1st and 3rd days after surgery, compared to the control group, the D-dimer level of patients in the observation group was distinctly fewer ( $P=0.001$ , $P=0.027$ ). Conclusion. TXA combined with compression bandage is a potential option for the reduction of bleeding after TKA.