Efficacy Of Bone Wax Combined With Tranexamic Acid In Total Knee Arthroplasty

Objective:To explore the safety and efficacy of bone wax combined with tranexamic acid in total knee arthroplasty.Methods:A total of 179 patients visited in our hospital for the primary TKA operation from 2017.09 to 2019.09 were screened.The patients were divided into three groups according to different hemostasis measures: group A: no bone wax and tranexamic acid were used;Group B: 1g tranexamic acid was injected intravenously and 3g/50 ml tranexamic acid solution was injected into the joint cavity after the capsule was closed;Group C: intravenous infusion of 1g tranexamic acid was administered 10 min before surgery,and 3g/50 ml tranexamic acid solution was injected into the joint cavity after the joint capsule was closed,bone wax was applied to cover the exposed osteotomy surface which was not covered by the knee prosthesis and the nail hole.General data and blood loss related indicators of the three groups of patients were collected for statistical analysis.Results:The total blood loss in group A(891.14±257.72ml)was significantly higher than that in group B(578.90±224.46ml)and group C(497.18±177.80),with statistical significance(p < 0.05).The difference between groups B and C was also statistically significant(p < 0.05),and the total blood loss in group C was significantly lower than that in group B.The decrease of Hb in group A(29.90±8.09g/L)on the first day after surgery was significantly higher than that in group B(14.48±7.16g/L)and group C(11.92±4.58g/L),and the difference was statistically significant(p < 0.05).On the thirddays after the operation,the decreased Hb value of group A(33.68±5.90g/L)was significantly higher than that of group B(20.90±5.66g/L)and group C(16.23±9.07g/L),and the difference was statistically significant(p < 0.05).The transfusion rate of group B(10.3%)was significantly lower than that of group A(28.8%),and that of group C(11.3%)was also significantly lower than that of group A,but the difference between group B and group C was not statistically significant.Conclusion:(1)Bone wax combined with tranexamic acid can significantly reduce the total blood loss during TKA surgery;(2)bone wax combined with tranexamic acid can effectively reduce the blood transfusion rate in TKA surgery,but the effect of reducing blood transfusion rate is not better than that of tranexamic acid alone.