Efficacy of Low-dose Intra-articular Tranexamic Acid in Total Knee Replacement

NCT ID: NCT01850394

Last Updated: 2013-12-13

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

152 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2012-01-31

Brief Summary

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The purpose of this study is to determine 1) the effective dosage of intra-articular tranexamic acid injection for controlling blood loss and blood transfusion requirement in conventional total knee replacement, and 2) whether the blood loss reduction effect depended on the dose of tranexamic acid used.

Detailed Description

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Conditions

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Primary Osteoarthritis of Knee Nos

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Control group

physiologic saline 25 ml

Group Type PLACEBO_COMPARATOR

Physiologic saline

Intervention Type DRUG

Use physiologic saline for mixing with tranexamic acid or use alone in placebo group

TXA-250 group

A total of 25-ml solution with 250-mg tranexamic acid

Group Type ACTIVE_COMPARATOR

Tranexamic Acid

Intervention Type DRUG

Inject tranexamic acid solution intra-articularly after fascia closure

Physiologic saline

Intervention Type DRUG

Use physiologic saline for mixing with tranexamic acid or use alone in placebo group

TXA-500 group

A total of 25-ml solution with 500-mg tranexamic acid

Group Type ACTIVE_COMPARATOR

Tranexamic Acid

Intervention Type DRUG

Inject tranexamic acid solution intra-articularly after fascia closure

Physiologic saline

Intervention Type DRUG

Use physiologic saline for mixing with tranexamic acid or use alone in placebo group

Interventions

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Tranexamic Acid

Inject tranexamic acid solution intra-articularly after fascia closure

Intervention Type DRUG

Physiologic saline

Use physiologic saline for mixing with tranexamic acid or use alone in placebo group

Intervention Type DRUG

Other Intervention Names

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Transmin

Eligibility Criteria

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Inclusion Criteria

* patients diagnosed as primary knee osteoarthritis and underwent unilateral primary cemented conventional total knee replacement
* no risk of abnormal bleeding tendency or bleeding disorder (normal coagulogram, serum creatinine \< 2.0 mg/dL, stop nonsteroidal anti-inflammatory drugs and antiplatelet drugs more than 7 days
* no contra-indication for tranexamic acid use (no active intravascular clotting process, no acquired defective colour vision, no subarachnoid hemorrhage, no hypersensitivity to TXA, and no any of history of serious adverse effects, thrombotic disorder and hematuria)

Exclusion Criteria

* incomplete data collection, for example, malfunctioned drain or accidental drain removal.
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mahidol University

OTHER

Sponsor Role lead

Responsible Party

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Viroj Kawinwonggowit

Clinical Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ramathibodi Hospital

Bangkok, , Thailand

Site Status

Countries

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Thailand

References

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Sa-Ngasoongsong P, Channoom T, Kawinwonggowit V, Woratanarat P, Chanplakorn P, Wibulpolprasert B, Wongsak S, Udomsubpayakul U, Wechmongkolgorn S, Lekpittaya N. Postoperative blood loss reduction in computer-assisted surgery total knee replacement by low dose intra-articular tranexamic acid injection together with 2-hour clamp drain: a prospective triple-blinded randomized controlled trial. Orthop Rev (Pavia). 2011;3(2):e12. doi: 10.4081/or.2011.e12. Epub 2011 Jun 29.

Reference Type BACKGROUND
PMID: 22053253 (View on PubMed)

Ishida K, Tsumura N, Kitagawa A, Hamamura S, Fukuda K, Dogaki Y, Kubo S, Matsumoto T, Matsushita T, Chin T, Iguchi T, Kurosaka M, Kuroda R. Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty. Int Orthop. 2011 Nov;35(11):1639-45. doi: 10.1007/s00264-010-1205-3. Epub 2011 Jan 21.

Reference Type BACKGROUND
PMID: 21253725 (View on PubMed)

Wong J, Abrishami A, El Beheiry H, Mahomed NN, Roderick Davey J, Gandhi R, Syed KA, Muhammad Ovais Hasan S, De Silva Y, Chung F. Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial. J Bone Joint Surg Am. 2010 Nov 3;92(15):2503-13. doi: 10.2106/JBJS.I.01518.

Reference Type BACKGROUND
PMID: 21048170 (View on PubMed)

Maniar RN, Kumar G, Singhi T, Nayak RM, Maniar PR. Most effective regimen of tranexamic acid in knee arthroplasty: a prospective randomized controlled study in 240 patients. Clin Orthop Relat Res. 2012 Sep;470(9):2605-12. doi: 10.1007/s11999-012-2310-y. Epub 2012 Mar 15.

Reference Type BACKGROUND
PMID: 22419350 (View on PubMed)

Roy SP, Tanki UF, Dutta A, Jain SK, Nagi ON. Efficacy of intra-articular tranexamic acid in blood loss reduction following primary unilateral total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2012 Dec;20(12):2494-501. doi: 10.1007/s00167-012-1942-5. Epub 2012 Mar 15.

Reference Type BACKGROUND
PMID: 22419263 (View on PubMed)

Seo JG, Moon YW, Park SH, Kim SM, Ko KR. The comparative efficacies of intra-articular and IV tranexamic acid for reducing blood loss during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2013 Aug;21(8):1869-74. doi: 10.1007/s00167-012-2079-2. Epub 2012 Jun 24.

Reference Type BACKGROUND
PMID: 22729012 (View on PubMed)

Sa-Ngasoongsong P, Wongsak S, Chanplakorn P, Woratanarat P, Wechmongkolgorn S, Wibulpolprasert B, Mulpruek P, Kawinwonggowit V. Efficacy of low-dose intra-articular tranexamic acid in total knee replacement; a prospective triple-blinded randomized controlled trial. BMC Musculoskelet Disord. 2013 Dec 5;14:340. doi: 10.1186/1471-2474-14-340.

Reference Type DERIVED
PMID: 24308672 (View on PubMed)

Other Identifiers

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ID 01-53-06

Identifier Type: -

Identifier Source: org_study_id