Tranexamic Acid for Unilateral Total Knee Arthroplasty

NCT ID: NCT01594671

Last Updated: 2012-12-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-02-29

Study Completion Date

2012-10-31

Brief Summary

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Total knee arthroplasty is often associated with excessive postoperative bleeding due to increased fibrinolysis. Hence, the objective of the proposed of this multicentre study is to determine the peri-operative bleeding comparing the application of topical and intravenous tranexamic acid with the habitual surgical haemostasis.

Detailed Description

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Objectives:

1. Principal: To assess if the topical and intravenous tranexamic acid reduce less or at least than 20% the blood losses with respect to the habitual haemostasia in patients, after unilateral total knee arthroplasty.
2. Secondary: To assess the treatment safety. To perform a cost- analyses.

Methods: Randomized, multicentre, open and parallel clinical trial with three comparative groups: Topical tranexamic acid, Intravenous tranexamic acid and habitual haemostasia. In all patients, a single drainage of 8mm will be inserted in the joint, and it will remain closed during one hour after the closure of the skin.

Nº of participant centres: 2. Random allocation will be centralised in "Hospital de la Santa Creu i Sant Pau".

Main outcome: Total blood loss (mL) in the post-operative period collected by the habitual drain system ).

Secondary outcomes: Total blood loss (mL)and hidden blood calculated by Nadler's formula. Proportion of patients with blood transfusion, complications of surgery wound, haemoglobin pre and post-operative, units of blood transfused, post-operative mortality, days of hospital stay, safety of interventions assessed.Direct cost analysis.

Substudy: Pharmacokinetic study. The first 24 patients included in "Hospital de la Santa Creu i Sant Pau" for tranexamic acid (12 topical- 12 intravenous) to determine:

1. Plasmatic concentrations of tranexamic acid
2. In topical and intravenous tranexamic acid administration determine the absorption rate and drug bioavailability by these routes: maximum plasma concentration, time to reach Cmax, AUC, and half-life.

Conditions

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Blood Loss

Keywords

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primary knee arthroplasty tranexamic acid topical

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Tranexamic acid

Intravenous Tranexamic Acid Two dosage Tranexamic acid during the surgical intervention: the first dosage 15-30' before the leg ischemia and the second dosage at 60 -90' after the first dosage.

Each dosage: 2 ampoules of 500mg/5 mL/ampoule Other Name: Amchafibrin

Group Type EXPERIMENTAL

Tranexamic Acid

Intervention Type DRUG

Two dosage during the surgical intervention: the first dosage 15-30' before the leg ischemia and the second dosage at 60 -90' after the first dosage.

Each dosage: 2 ampoules of 500mg/5 mL/ampoule

haemostasia

Intervention Type OTHER

The surgical habitual haemostasia: electrocoagulation of the bleeding tissues

Habitual haemostasia

The surgical habitual haemostasia.

Group Type ACTIVE_COMPARATOR

haemostasia

Intervention Type OTHER

The surgical habitual haemostasia: electrocoagulation of the bleeding tissues

Topical Tranexamic acid

Topical Tranexamic acid one dose before the closure of the knee joint: a solution containing 1g of tranexamic acid in 50 ml of normal saline (0.9% sodium chloride) applied with a syringe diffuser.

Group Type EXPERIMENTAL

Tranexamic Acid

Intervention Type DRUG

One dose before the closure of the knee joint: a solution containing 1g of tranexamic acid in 50 ml of normal saline (0.9% sodium chloride) applied with a syringe diffuser.

haemostasia

Intervention Type OTHER

The surgical habitual haemostasia: electrocoagulation of the bleeding tissues

Interventions

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Tranexamic Acid

Two dosage during the surgical intervention: the first dosage 15-30' before the leg ischemia and the second dosage at 60 -90' after the first dosage.

Each dosage: 2 ampoules of 500mg/5 mL/ampoule

Intervention Type DRUG

Tranexamic Acid

One dose before the closure of the knee joint: a solution containing 1g of tranexamic acid in 50 ml of normal saline (0.9% sodium chloride) applied with a syringe diffuser.

Intervention Type DRUG

haemostasia

The surgical habitual haemostasia: electrocoagulation of the bleeding tissues

Intervention Type OTHER

Other Intervention Names

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Amchafibrin Amchafibrin

Eligibility Criteria

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Inclusion Criteria

* Unilateral Total knee arthroplasty
* The patient consent to participate

Exclusion Criteria

* Antecedent of thromboembolic disease
* Patient with cardiac alterations of the rhythm
* Patients with valvular cardiac prosthesis
* Patients with pro-thrombotic alterations of coagulation
* Treatment with anticonceptive drugs
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Aguilera X, M.D

Role: PRINCIPAL_INVESTIGATOR

Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau

Martinez-Zapata MJ, PhD

Role: STUDY_DIRECTOR

Centro Cochrane Iberoamericano. IIB Sant Pau

Locations

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Hospital de la Esperanza

Barcelona, Barcelona, Spain

Site Status

Hospital de la Santa Creu i Sant Pau

Barcelona, Barcelona, Spain

Site Status

Countries

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Spain

Other Identifiers

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IIBSP-ATR-2010-23

Identifier Type: -

Identifier Source: org_study_id