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Authors Meng Y, Li Z, Gong K, An X, Dong J, Tang P
Received 18 December 2017
Accepted for publication 5 March 2018
Published 12 April 2018 Volume 2018:14 Pages 675—683
DOI https://doi.org/10.2147/TCRM.S160156
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Hoa Le
Peer reviewer comments 4
Editor who approved publication: Professor Deyun Wang
Purpose: Obesity can result in increased blood loss, which is correlated
with poor prognosis in total knee arthroplasty (TKA). Clinical application of
tranexamic acid is effective in reducing blood loss in TKA. However, most
previous studies focused on the effect of tranexamic acid in the whole
population, neglecting patients with specific health conditions, such as
obesity. We hypothesized that tranexamic acid would reduce blood loss to a
greater extent in obese patients than in those of normal weight.
Patients and
methods: A total of 304 patients with knee
osteoarthritis treated with TKA from October 2013 to March 2015 were separated
into tranexamic, non-tranexamic, obese, and non-obese groups. The demographic
characteristics, surgical indices, and hematological indices were all recorded.
We first investigated the ability of intravenous tranexamic acid to reduce
intraoperative blood loss in knee osteoarthritis patients undergoing unilateral
TKA. Second, we performed subgroup analysis to compare the effects of
tranexamic acid between obese and non-obese patients separately.
Results: Of the 304 patients, 146 (52.0%) received tranexamic acid and 130
(42.8%) were obese. In the analysis of the whole group, both the actual and
occult blood loss volume were lower in the tranexamic acid group (both P < 0.05). Tourniquet time
was shorter in the tranexamic acid group (P < 0.05).
In subgroup analysis, tranexamic acid was shown to reduce theoretical and
actual blood loss in both the obese and non-obese groups (P < 0.05). Tranexamic acid
reduced occult blood loss and tourniquet time in the obese group (P < 0.05), while no such
effects were observed in the non-obese group (P >
0.05).
Conclusion: Tranexamic acid can reduce occult blood loss and tourniquet time in
obese patients to a greater extent than in patients of normal weight.
Therefore, obese knee osteoarthritis patients undergoing TKA can benefit more
from tranexamic acid.
Keywords: obese, knee osteoarthritis, total knee arthroplasty, blood conservation,
tranexamic acid