Silong Lin, Xianqi Zhang, Xishang Xia, Guishui Xu, Hong Pan
{"title":"氨甲环酸对全膝关节置换术围手术期炎症、长期功能恢复和满意度的影响：一项随访研究。","authors":"Silong Lin, Xianqi Zhang, Xishang Xia, Guishui Xu, Hong Pan","doi":"10.2147/JIR.S532632","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To explore the anti-inflammatory effects and safety of Tranexamic Acid (TXA) during the perioperative period of Total Knee Arthroplasty (TKA) in patients with Knee Osteoarthritis (KOA), and to follow-up on long-term knee joint function and patient satisfaction.</p><p><strong>Methods: </strong>A prospective non-randomized controlled cohort study evaluated TXA efficacy in 130 unilateral TKA patients with KOA between January 2019 and March 2021. Patients were randomized into TXA (n=65) and control (n=65) groups. The TXA group received both intravenous and intra-articular TXA as required Postoperative coagulation profiles, day-3 systemic inflammatory markers, 6-month DVT/complication rates, and 2-year functional outcomes (knee function, QoL [Quality of Life], satisfaction) were assessed.</p><p><strong>Results: </strong>No significant differences in demographics, clinical data, or KOA severity were observed between the control and TXA groups (P>0.05). Only TXA group showed decreased post-operative Fibrinogen (FIB) levels, while Erythrocyte Sedimentation Rate (ESR)(decreased to 15.41 ±4.39 mm/h), C-reactive Protein (CRP) (decreased to 33.32 ±11.56 mg/L), and Interleukin 6 (IL-6) levels significantly decreased (decreased to 111.38 ±30.14 μg/mL) on the third day post-operation (P<0.001). During the 6 months, specific complications did not significantly differ, but the overall complication rate notably decreased in the TXA group (OR=0.23, 95% CI 0.08 to 0.61, P = 0.012). At 2-year follow-up, TXA group showed significantly better joint function and QoL (P<0.05). Postoperative satisfaction correlated with preoperative TXA use, neutrophil count, NLR, ESR, and CRP. Multivariate analysis identified TXA as an independent predictor of satisfaction (P<0.05). TXA group exhibited reduced inflammation, lower complication rates, and improved long-term outcomes, demonstrating favorable perioperative and long-term outcomes in KOA management.</p><p><strong>Conclusion: </strong>TXA has a significant effect on perioperative inflammation, long-term functional recovery and satisfaction in TKA.</p>","PeriodicalId":16107,"journal":{"name":"Journal of Inflammation Research","volume":"18 ","pages":"12769-12781"},"PeriodicalIF":4.1000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447970/pdf/","citationCount":"0","resultStr":"{\"title\":\"Study on the Effects of Tranexamic Acid on Perioperative Inflammation, Long-Term Functional Recovery, and Satisfaction in Total Knee Arthroplasty: A Follow-up Study.\",\"authors\":\"Silong Lin, Xianqi Zhang, Xishang Xia, Guishui Xu, Hong Pan\",\"doi\":\"10.2147/JIR.S532632\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To explore the anti-inflammatory effects and safety of Tranexamic Acid (TXA) during the perioperative period of Total Knee Arthroplasty (TKA) in patients with Knee Osteoarthritis (KOA), and to follow-up on long-term knee joint function and patient satisfaction.</p><p><strong>Methods: </strong>A prospective non-randomized controlled cohort study evaluated TXA efficacy in 130 unilateral TKA patients with KOA between January 2019 and March 2021. Patients were randomized into TXA (n=65) and control (n=65) groups. The TXA group received both intravenous and intra-articular TXA as required Postoperative coagulation profiles, day-3 systemic inflammatory markers, 6-month DVT/complication rates, and 2-year functional outcomes (knee function, QoL [Quality of Life], satisfaction) were assessed.</p><p><strong>Results: </strong>No significant differences in demographics, clinical data, or KOA severity were observed between the control and TXA groups (P>0.05). Only TXA group showed decreased post-operative Fibrinogen (FIB) levels, while Erythrocyte Sedimentation Rate (ESR)(decreased to 15.41 ±4.39 mm/h), C-reactive Protein (CRP) (decreased to 33.32 ±11.56 mg/L), and Interleukin 6 (IL-6) levels significantly decreased (decreased to 111.38 ±30.14 μg/mL) on the third day post-operation (P<0.001). During the 6 months, specific complications did not significantly differ, but the overall complication rate notably decreased in the TXA group (OR=0.23, 95% CI 0.08 to 0.61, P = 0.012). At 2-year follow-up, TXA group showed significantly better joint function and QoL (P<0.05). Postoperative satisfaction correlated with preoperative TXA use, neutrophil count, NLR, ESR, and CRP. Multivariate analysis identified TXA as an independent predictor of satisfaction (P<0.05). TXA group exhibited reduced inflammation, lower complication rates, and improved long-term outcomes, demonstrating favorable perioperative and long-term outcomes in KOA management.</p><p><strong>Conclusion: </strong>TXA has a significant effect on perioperative inflammation, long-term functional recovery and satisfaction in TKA.</p>\",\"PeriodicalId\":16107,\"journal\":{\"name\":\"Journal of Inflammation Research\",\"volume\":\"18 \",\"pages\":\"12769-12781\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447970/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Inflammation Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/JIR.S532632\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Inflammation Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/JIR.S532632","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Study on the Effects of Tranexamic Acid on Perioperative Inflammation, Long-Term Functional Recovery, and Satisfaction in Total Knee Arthroplasty: A Follow-up Study.
Purpose: To explore the anti-inflammatory effects and safety of Tranexamic Acid (TXA) during the perioperative period of Total Knee Arthroplasty (TKA) in patients with Knee Osteoarthritis (KOA), and to follow-up on long-term knee joint function and patient satisfaction.
Methods: A prospective non-randomized controlled cohort study evaluated TXA efficacy in 130 unilateral TKA patients with KOA between January 2019 and March 2021. Patients were randomized into TXA (n=65) and control (n=65) groups. The TXA group received both intravenous and intra-articular TXA as required Postoperative coagulation profiles, day-3 systemic inflammatory markers, 6-month DVT/complication rates, and 2-year functional outcomes (knee function, QoL [Quality of Life], satisfaction) were assessed.
Results: No significant differences in demographics, clinical data, or KOA severity were observed between the control and TXA groups (P>0.05). Only TXA group showed decreased post-operative Fibrinogen (FIB) levels, while Erythrocyte Sedimentation Rate (ESR)(decreased to 15.41 ±4.39 mm/h), C-reactive Protein (CRP) (decreased to 33.32 ±11.56 mg/L), and Interleukin 6 (IL-6) levels significantly decreased (decreased to 111.38 ±30.14 μg/mL) on the third day post-operation (P<0.001). During the 6 months, specific complications did not significantly differ, but the overall complication rate notably decreased in the TXA group (OR=0.23, 95% CI 0.08 to 0.61, P = 0.012). At 2-year follow-up, TXA group showed significantly better joint function and QoL (P<0.05). Postoperative satisfaction correlated with preoperative TXA use, neutrophil count, NLR, ESR, and CRP. Multivariate analysis identified TXA as an independent predictor of satisfaction (P<0.05). TXA group exhibited reduced inflammation, lower complication rates, and improved long-term outcomes, demonstrating favorable perioperative and long-term outcomes in KOA management.
Conclusion: TXA has a significant effect on perioperative inflammation, long-term functional recovery and satisfaction in TKA.
期刊介绍：
An international, peer-reviewed, open access, online journal that welcomes laboratory and clinical findings on the molecular basis, cell biology and pharmacology of inflammation.
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