Low-dose exposure to tranexamic acid has no significant toxic effect on human cartilage

IF 1.6 4区医学 Q3 ORTHOPEDICS

Knee Pub Date : 2025-07-15 DOI:10.1016/j.knee.2025.06.019

Arash Sherafatvaziri , Mohammad Hossein Nabian , Fardis Vosoughi , Elham Madreseh , Alireza Mirzamohamadi , Ramin Shayan-moghadam

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引用次数: 0

Abstract

Background

Recent studies have raised concerns about the potential cytotoxic effects of tranexamic acid (TXA) on cartilage. This study aimed to evaluate the safety of low-dose TXA exposure on human cartilage.

Method

In this ex-vivo study, 30 patients with a varus osteoarthritic knee undergoing total knee arthroplasty (TKA) were enrolled. During the surgery, a set of six osteochondral plugs was harvested from the apparently intact lateral condyle of each patient’s femur, resulting in a total of 180 plugs. Subsequently, all three plugs of each set were randomly exposed to one of the TXA treatment groups: 1 mg/ml (TI group), 5 mg/ml (TV group), or 10 mg/ml (TX group) of TXA. The remaining three plugs of each set were assigned to the control group and exposed to 0.9 % saline as a match for comparison. The effects of TXA dose and exposure time on cell viability were assessed using acridine orange/propidium iodide staining at baseline, 3, and 6 h post-exposure.

Results

Cell viability decreased over time in the TI, TV, TX, and control groups compared with their baselines (P = 0.006, P < 0.001, P = 0.001, P < 0.001, respectively). However, the differences in the trend of decline were not statistically significant between groups (P = 0.3), and direct comparisons among TXA concentrations and saline control at baseline, 3, and 6 h after exposure showed no statistically significant difference in cell death (P = 0.538, P = 0.256, P = 0.287, respectively).

Conclusions

Exposure to low-dose TXA (≤10 mg/ml) for up to 6 h did not cause significant toxic effects on human cartilage.

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低剂量暴露于氨甲环酸对人体软骨没有明显的毒性作用

最近的研究引起了人们对氨甲环酸（TXA）对软骨的潜在细胞毒性作用的关注。本研究旨在评估低剂量TXA暴露对人体软骨的安全性。方法在这项离体研究中，入选了30例接受全膝关节置换术（TKA）的内翻性骨关节炎膝关节患者。在手术中，从每位患者的股骨外侧髁上取下一组6个骨软骨塞，共180个塞。随后，每组的所有三个插头随机暴露于TXA处理组之一：1mg /ml （TI组），5mg /ml （TV组）或10mg /ml （TX组）的TXA。每组的其余三个塞被分配给对照组，并暴露于0.9%的生理盐水中作为比较的匹配。使用吖啶橙/碘化丙啶染色法在基线、暴露后3和6小时评估TXA剂量和暴露时间对细胞活力的影响。结果TI组、TV组、TX组和对照组的细胞活力随着时间的推移而下降(P = 0.006, P <；0.001, P = 0.001, P <；分别为0.001)。但各组间下降趋势差异无统计学意义（P = 0.3），暴露后基线、3、6 h TXA浓度与生理盐水对照直接比较，细胞死亡差异无统计学意义（P = 0.538、P = 0.256、P = 0.287）。结论低剂量TXA（≤10 mg/ml）暴露6h对人体软骨没有明显的毒性作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.