Abstract
Background
The purpose of this study was to compare the efficacy of tranexamic acid versus placebo
after arthroscopic rotator cuff repair.
Methods
This prospective, double-blind, and randomized study involved 66 patients who consecutively
underwent arthroscopic rotator cuff repair from 2020 to 2021 at our hospital. Thirty-three
shoulders each were randomly assigned to the tranexamic acid and control groups. In
the former group, 1000 mg of tranexamic acid (20 mL) was administered intravenously
10 min before surgery and the same volume of normal saline (20 mL) was administered
intravenously in the control group. We evaluated visual clarity; visual analog scale
pain scores at rest, during activity, and at night; the circumference and diameter
of the shoulder joint in the groups before and after the surgery at 1, 2, and 3 days,
and 1 week; estimated perioperative blood loss; and operative time. Visual clarity
was rated using a numeric rating scale from grade 1 (poor) to grade 3 (clear) every
15 min throughout the surgery. We compared and analyzed the results between the groups.
Statistical significance was set at a p-value of <0.05.
Results
Visual clarity was found to be significantly better in the tranexamic acid group,
with a greater percentage of grade 3 visual clarity (75.6 ± 11.2% vs 68.1 ± 13.4%,
p = 0.045). The visual analog scale scores at rest and at night in the control group
were significantly lower than those in the tranexamic acid group for 1 week postoperatively
(13.8 ± 14.8 vs 5 ± 9.3, p = 0.008, 36.1 ± 23.3 vs 19.3 ± 24, p = 0.012). The circumference
and diameter of the shoulder joint, estimated perioperative blood loss, and operative
time were not significantly different between the two groups.
Conclusion
Intravenous administration of tranexamic acid is an alternative way to improve visual
clarity in arthroscopic rotator cuff repair; however, there are no other significant
differences compared to the administration of placebo.
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Article info
Publication history
Published online: December 20, 2021
Accepted:
November 24,
2021
Received in revised form:
October 22,
2021
Received:
June 30,
2021
Identification
Copyright
© 2021 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.
