Effects of Oral Tranexamic Acid Following Total Knee Arthroplasty

NCT ID: NCT06479161

Last Updated: 2024-12-13

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

RECRUITING

Clinical Phase

PHASE2

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-06-10

Study Completion Date

2025-03-30

Brief Summary

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The primary purpose of this study is to evaluate postoperative pain. Secondary outcomes evaluated in this study will include range of motion (ROM), opioid consumption, and ambulation. Each outcome measure will be evaluated, oral tranexamic acid (TXA) in the experiment arm and placebo in the control arm, after total knee arthroplasty (TKA) at postoperative days 0-3, and weeks 1, 2, 6, and 12.

Detailed Description

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Randomized controlled trial with 1:1 allocation, selected through computer-based randomization.

This study will review prospectively collected data, including patient demographic information, surgeon, use of oral tranexamic acid (TXA) or placebo regimen, and postoperative outcomes up to 3 months after surgery. Collaboration with Saint Francis' pharmacy team will be performed to ensure appropriate blinded administering of the oral TXA and placebo medication.

This will be a double blinded study, with both patient and surgeon blinded to study group.

6.0 TXA dosing protocol TXA day of surgery \[All patients\]

* Administer 1-gram IV TXA intraoperatively at the start of the case (hold for history of stent within 1 year of surgery)

o AND
* Administer 1-gram IV TXA postoperatively before leaving PACU (hold for history of stent within 1 year of surgery)

o OR
* Exception: Administer 2 grams TXA in 50cc normal saline topically during the case for patients with a history of stent placed within one year of surgery.

TXA postoperative day (POD) 1-3 \[Experimental group\]

* Administer 1.95 grams oral (3- 650 mg tablets) TXA each morning for three days following surgery.
* Patients discharged home before POD 3 will be sent home with remaining oral TXA doses.

Placebo POD 1-3 \[Control group\]

* Administer oral placebo (3 tablets) each morning for three days following surgery.
* Patients discharged home before POD 3 will be sent home with remaining oral placebo doses.

Conditions

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Postoperative Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
This will be a double blinded study, with both patient and surgeon blinded to study group.

Collaboration with Saint Francis' pharmacy team will be performed to ensure appropriate blinded administering of the oral TXA and placebo medication.

Study Groups

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TXA

\- 1.95 grams oral TXA (tranexamic acid) (3- 650 mg tablets) administered postop day one, postop day two and postop day three. Compounded by registered pharmacist and labeled with subject name and instructions for use.

Group Type ACTIVE_COMPARATOR

Tranexamic acid

Intervention Type DRUG

1.95 grams oral

Placebo

\- 3 tablets administered postop day one, postop day two and postop day three. Compounded by registered pharmacist and labeled with subject name and instructions for use.

Group Type PLACEBO_COMPARATOR

Tranexamic acid

Intervention Type DRUG

1.95 grams oral

Interventions

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Tranexamic acid

1.95 grams oral

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* \- All patients undergoing either manual or robotic primary total knee arthroplasty (TKA)
* Performed by participating Connecticut Joint Replacement Institute (CJRI) surgeons (Dr. Matthew Grosso, Dr. Robert McAllister, Dr. Chad Daniel, Dr. Eric Silverstein, Dr. Alex Dukas, Dr. Michael Joyce, Dr. Brett Wasserlauf).
* Male and female patient age 18-89
* Primary diagnosis of knee osteoarthritis

Exclusion Criteria

* Revision TKA
* No exclusion based on gender
* Patients \<18 and \>89 years old
* Exclusion for IV oral tranexamic acid (TXA):

* TXA allergy - there are NO absolute contraindications for TXA use.
* History of stent placed within one year of surgery - patient will receive topical TXA as an alternative.
* Exclusion for oral TXA:

o Actively treated cancer or deep vein thrombosis (DVT)
* Chronic opioid use (opioid use within the 4 weeks prior to surgery)
* Allergies to nonsteroidal Anti-inflammatory drugs (NSAIDs) and acetaminophen
* Patients with clinically significant drug interactions
* Pre-existing neuropathy
* Current or previous venous thrombosis (DVT or venous stasis disease)
* Immuno-compromised secondary to medical condition
* Immune-suppressive medications, chemotherapy
* Pregnancy, breast feeding
* History of pain catastrophizing. Major depressive disorder
* History of suspected or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years.
* Currently on a neuroleptic agent \[e.g., gabapentin, pregabalin (Lyrica), duloxetine (Cymbalta) etc.\].
* Non-English speaking and reading patient populations
* Any clinically significant event or condition uncovered during the surgery (e.g., excessive bleeding, acute sepsis) that, in the opinion of the investigator, renders the subject medically unstable or complicates the subject's post-operative course.
Minimum Eligible Age

18 Years

Maximum Eligible Age

89 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Matthew Grosso, MD

OTHER

Sponsor Role lead

Responsible Party

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Matthew Grosso, MD

Director, Quality and Outcomes Research

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Trinity Health Of New England/CT Joint Replacement Institute

Hartford, Connecticut, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Gina Panek, BS

Role: CONTACT

Phone: 860-714-4164

Email: [email protected]

Czarina Weinz

Role: CONTACT

Phone: 860-714-0467

Email: [email protected]

Facility Contacts

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Gina Panek, BS

Role: primary

Czarina Weinz

Role: backup

Other Identifiers

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SFH 24-05

Identifier Type: -

Identifier Source: org_study_id