Purpose
To evaluate the effect of tranexamic acid (TXA) in patients undergoing anterior cruciate
ligament (ACL) reconstruction in reducing intra-articular effusion and affecting clinical
outcomes 3 months after surgery.
Methods
Eighty consecutive patients undergoing ACL reconstruction were prospectively assessed
from 2014 to 2016. Patients were randomly allocated to 1 of 2 groups: The test group
received an intravenous infusion of 15 mg/kg of TXA, and the control group did not
receive TXA. The patellar circumference, range of motion (ROM), Coupens and Yates
(CY) value, visual analog scale score for pain assessment, and quadriceps strength
(QS) were considered on postoperative day (PD) 1, PD 7, and PD 15 and at 1 month and
3 months after surgery. Blood volume in the intra-articular drainage was recorded
on PD 1. Any adverse effect, such as fever onset (>37.5°C), hemarthrosis, or infection,
was also considered.
Results
We found a statistically significant reduction in drainage blood volume (P < .001) and CY value (P = .0044) on PD 1 in patients in the test group compared with those in the control
group. On PD 7, a significant improvement was found for mean CY values (P = .0057), ROM (P = .0031), and QS (P = .015). On PD 15, we noted significant improvements in CY values (P < .001), patellar circumference (P = .0019), QS (P = .0089), and visual analog scale values (P = .0032) in the test group. We noted 13 fever episodes in the control group and 2
fever episodes in the study group (P = .047). No differences for any outcomes or complications were found at 3 months.
Conclusion
TXA administration reduced hemarthrosis and the amount of suction drainage blood volume,
improved ROM and QS, and reduced fever episodes during the first 2 weeks after surgery.
TXA use improved early-phase outcomes in the postoperative period after ACL reconstruction.
Level of Evidence
Level I, randomized controlled trial.
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Article info
Publication history
Accepted:
July 31,
2018
Received:
March 29,
2018
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2018 by the Arthroscopy Association of North America
