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DOI: https://doi.org/10.22263/2312-4156.2021.6.35

Khadzkou Y.K., Balaboshka K.B.
Comparative effectiveness of the fibrinolysis inhibitors in knee replacement
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2021;20(6):35-42.

Abstract.
Objectives. To determine the effectiveness of the developed method of combined use of the fibrinolysis inhibitor aminocaproic acid, including intravenous administration and local application, during knee replacement.
Material and methods. A prospective randomized study included 80 patients who had undergone total knee replacement. In the treatment of group 1 patients, the method of combined use of aminocaproic acid, including intravenous and local administration, was used. Intravenous administration of aminocaproic acid was used in the treatment of group 2 patients. Intravenous administration of tranexamic acid was used in the treatment of group 3 patients. Group 4 patients underwent operations without the application of fibrinolysis inhibitors. The indices of hemoglobin, erythrocytes, hematocrit number, blood loss volume, functional result, and also the economic costs were evaluated.
Results. On the 1st and the 5th days after the operation, statistically significantly higher hemoglobin values of 129±11/120±12 g/l, the number of red blood cells 4.4±0.4/4.1±0.4*1012/l, hematocrit number 38±2.2/36±3.3 were obtained in patients of group 1 (p<0.05). The average volume of blood loss of 860 (602;1098) ml was statistically significantly lower in group 1 (p<0.05). The effective reduction of blood loss made it possible to achieve a better functional result, to eliminate the need for hemotransfusion and to reduce the economic costs in the treatment of group 1 patients.
Conclusions. The developed method of combined use of the fibrinolysis inhibitor aminocaproic acid in knee arthroplasty, including intravenous administration and local application, provides favorable conditions for early activation of a patient, improves the functional result and cuts the economic costs by reducing blood loss.
Key words: knee replacement, blood loss, fibrinolysis inhibitors, aminocaproic acid, rehabilitation.

References

1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007 Apr;89(4):780-5. doi: http://dx.doi.org/10.2106/JBJS.F.00222
2. Hu Y, Li Q, Wei B-G, Zhang X-S, Torsha TT, Xiao J, et al. Blood loss of total knee arthroplasty in osteoarthritis: an analysis of influential factors. J Orthop Surg Res. 2018 Dec 22;13(1):325. doi: http://dx.doi.org/10.1186/s13018-018-1038-0
3. Themistoklis T, Theodosia V, Konstantinos K, Georgios DI. Perioperative blood management strategies for patients undergoing total knee replacement: Where do we stand now? World J Orthop. 2017 Jun 18;8(6):441-54. doi: http://dx.doi.org/10.5312/wjo.v8.i6.441
4. Cardone D, Klein AA. Perioperative blood conservation. Eur J Anaesthesiol. 2009 Sep;26(9):722-9. doi: http://dx.doi.org/10.1097/EJA.0b013e32832c5280
5. Riaz O, Aqil A, Asmar S, Vanker R, Hahnel J, Brew C, et al. Epsilon-aminocaproic acid versus tranexamic acid in total knee arthroplasty: a meta-analysis study. J Orthop Traumatol. 2019 Jul 18;20(1):28. doi: http://dx.doi.org/10.1186/s10195-019-0534-2
6. Khodkov EK, Boloboshko KB, Kubrakov KM, Usovich AK, Lovikov DN. Comparative effectiveness of analgesic methods for knee arthroplasty. Vestn VGMU. 2020;19(1):66-72. (In Russ.)
7. Boloboshko KB, Khodkov EK, Kubrakov KM, Abdulina ZN. The effectiveness of an integrated approach to perioperative maintenance of knee arthroplasty. Novosti khirurgii. 2020;28(1):53-61. (In Russ.)
8. Fillingham YA, Ramkumar DB, Jevsevar DS, Yates AJ, Shores P, Mullen K, et al. The efficacy of tranexamic acid in total knee arthroplasty: a network meta-analysis. J Arthroplasty. 2018 Oct;33(10):3090-8. doi: http://dx.doi.org/10.1016/j.arth.2018.04.043
9. Moskal JT, Capps SG. Intra-articular tranexamic acid in primary total knee arthroplasty: meta-analysis. J Knee Surg. 2018 Jan;31(1):56-67. doi: http://dx.doi.org/10.1055/s-0037-1600092

Information about authors:
Khadzkou Y.K. – lecturer of the Chair of Traumatology, Orthopedics & Military Surgery, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0002-9216-7929
Balaboshka K.B. – Candidate of Medical Sciences, associate professor, head of the Chair of Traumatology, Orthopedics & Military Surgery, Vitebsk State Order of Peoples’ Friendship Medical University,
ORCID: https://orcid.org/0000-0002-5599-3439

Correspondence address: Republic of Belarus, 210009, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Traumatology, Orthopedics & Military Surgery. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Yauheni K. Khadzkou.

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