INTRAARTICULAR EPSILON AMINOCAPROIC ACID VERSUS TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY

• Published in: Acta ortopedica brasileira Vol. 29; no. 6; pp. 312 - 315
• Main Authors: Guerreiro, Joao Paulo Fernandes, Balbino, Jose Rodolfo Martines, Rodrigues, Bruno Possani, Danieli, Marcus Vinicius, Queiroz, Alexandre Oliveira, Cataneo, Daniele Cristina
• Format: Journal Article
• Language: English
• Published: Brazil ATHA EDITORA 01-11-2021; Sociedade Brasileira de Ortopedia e Traumatologia
• Subjects: Bleeding; Epsilon Aminocaproic Acid; Original; ORTHOPEDICS; Pain; Total Knee Arthroplasty; Tranexamic Acid; Pain; Tranexamic Acid; Total Knee Arthroplasty; Epsilon Aminocaproic Acid; Bleeding; Ácido Tranexâmico; Ácido Épsilon Aminocapróico; Dor; Artroplastia Total do Joelho; Sangramento
• ISSN: 1413-7852; 1809-4406; 1809-4406
• DOI: 10.1590/1413-785220212906242008

To examine and compare the clinical efficacy of intraarticular epsilon aminocaproic acid (EACA) and tranexamic acid (TXA) in total knee arthroplasty (TKA).
This study was a prospective, single-center, double-blinded randomized controlled trial, including sixty patients with osteoarthritis of the knee divided into two groups of 30 patients. In the TXA group, 1 g of TXA (0.05 g/ml) was applied intraarticularly, and in the EACA group, 4 g of EACA (0.2 g/ml) was applied intraarticularly. Serum hemoglobin (Hgb) and hematocrit (Htb) were measured during the preoperatively and 24 and 48 hours postoperatively. The range of motion and pain were evaluated by clinical examination. To evaluate knee function before and 2 months after surgery, the Western Ontario and McMaster Universities Index (WOMAC) questionnaire was used.
In total, 56 (93.3%) patients were evaluated up to the second postoperative month. No significant difference between the groups (p > 0.05) was found in the decrease in Hgb or Htb at 24 or 48 hours. Regarding assessment of the pain, WOMAC score and gain in knee flexion, no significant advantages up to 60 days after surgery (p > 0.05) were found.
The decrease in Hgb and Htb during the first 48 hours postoperatively and the risk of transfusion were similar with the intraarticular use of 1 g of TXA and 4 g of EACA in TKA. The possible benefits regarding knee pain, gain in flexion and function were also similar for the two drugs.