gms | German Medical Science

Objectives: The hypothesis of the present study was that the use of TXA in medial open wedge HTO leds to less pain, better ROM, less swelling and less intraarticular effusion and therefore reduces postoperative morbidity.

Methods: A prospective non-randomized comparative study with 52 patients has been performed. In both treatment groups the same surgical technique for the medial open wedge HTO was used. In order to demonstrate a clinically relevant difference in the hemoglobin drop of 1.0 g / dl in the two treatment groups in a two-sided t-test with 80% power and a significance level of 0.05, at least 17 patients are required in each group. The case calculation was carried out with G * Power (version 3.1.7.7). In group 1 (N: 26) the patients received 1 g TXA i.v. preoperatively, in group 2 (N: 26) no TXA was given. Primary outcome measure was the decrease in hemoglobin concentration. Secondary outcome criteria were postoperative pain, intraarticular effusion (measured by ultrasound), range of motion (ROM) at discharge, peri- and postoperative complications and the KOOS PS (pre- and postoperatively at one year follow up).

Results and Conclusion: Hemoglobin decrease was significantly less in the TXA group compared to the non TXA group. Postoperative pain and intraarticular effusion was also significantly lower and ROM at discharge was higher in the TXA group. There was no group difference in peri- and postoperative complications and the pre- and postoperatively KOOS PS. The results of the present study show the systemic application of 1 g TXA reduces hemoglobin drop and postoperative morbidity (pain, intraarticular effusion, and ROM) after tibial open wedge HTO.