COMPARATIVE EFFECTIVENESS OF THE FIBRINOLYSIS INHIBITORS IN KNEE REPLACEMENT

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.