INTRAARTICULAR EPSILON AMINOCAPROIC ACID VERSUS TRANEXAMIC ACID IN TOTAL KNEE ARTHROPLASTY

Area of Science:

• Orthopedic Surgery
• Pharmacology
• Clinical Trials

Background:

• Total knee arthroplasty (TKA) can lead to significant blood loss.
• Antifibrinolytic agents are used to reduce bleeding in TKA.
• Intraarticular administration of epsilon aminocaproic acid (EACA) and tranexamic acid (TXA) is being explored for efficacy.

Purpose of the Study:

• To compare the clinical effectiveness of intraarticular EACA versus TXA in patients undergoing TKA.
• To evaluate the impact of these agents on blood loss, pain, range of motion, and knee function.

Main Methods:

• A prospective, single-center, double-blinded randomized controlled trial was conducted.
• Sixty patients with knee osteoarthritis were randomized into two groups (30 each) receiving either intraarticular TXA (1g) or EACA (4g).
• Hemoglobin, hematocrit, pain, range of motion, and knee function (WOMAC) were assessed preoperatively and postoperatively.

Main Results:

• No significant differences were observed between the TXA and EACA groups in the decrease of hemoglobin or hematocrit at 24 and 48 hours postoperatively.
• Clinical assessments of pain, WOMAC scores, and knee flexion gain showed no significant advantages for either treatment up to 60 days.
• The study evaluated 56 out of 60 patients up to the second postoperative month.

Conclusions:

• Intraarticular administration of 1g TXA and 4g EACA in TKA yields similar results regarding postoperative blood loss and transfusion risk.
• Both agents demonstrated comparable effects on knee pain, range of motion, and functional recovery in the early postoperative period.
• The study suggests equivalent clinical efficacy for intraarticular EACA and TXA in TKA patients.