Tranexamic acid may be used to decrease pain, swelling after arthroscopic surgery
Tranexamic acid decreases postoperative pain, swelling, drainage output, joint aspirations and hemarthrosis in patients undergoing arthroscopic surgery, with no increase in complications or operative time, results showed.
In April 2020, researchers performed a systematic review and meta-analysis of seven randomized controlled trials, which included 724 total patients (mean age, 33.9 years) who underwent various arthroscopic surgeries. Four studies included 537 patients who underwent ACL reconstruction, one study included 45 patients who underwent meniscectomy, one study included 70 patients who underwent surgery for femoroacetabular impingement and one study included 72 patients who underwent rotator cuff repair. Among the 724 patients, 396 patients (54.7%) received TXA during their respective procedures. Outcome measures included pain, blood loss, length of surgery and complications.
Compared with the non-TXA groups at 2 weeks postoperatively, the TXA groups had lower visual analog scale pain scores (mean difference, –1.65), decreased rates of patients requiring joint aspiration (RR = 0.27), decreased drainage output (mean difference, –61.14 ml) and decreased rates of hemarthrosis (mean difference, –0.76), according to the study. The researchers also noted no differences in operative time or incidence of deep vein thrombosis, infection and arthrofibrosis between the two groups.
“Although TXA has been studied extensively within certain areas of orthopedics, and in particular open surgery, there is also growing interest in its application to arthroscopic procedures,” the researchers wrote in the study.
“These findings indicate that TXA may be a useful adjunct in arthroscopic knee and shoulder surgery,” they added.