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Intrafocal injection of tranexamic acid decreases early return to hospital after high tibial osteotomy

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

High tibial osteotomy (HTO) is a surgery performed to treat the symptoms and prevent the progression of medial osteoarthritis. Post-operative bleeding has led to early returns to hospital following surgery. Intrafocal injection of tranexamic acid (TXA) could reduce this bleeding complication. The objective of the study was to evaluate the effect of TXA during HTO on the incidence of post-operative complications and early returns to hospital.

Materials and methods

This retrospective study included 251 cases of HTO performed between May 2012 and October 2021, with the use of TXA introduced in May 2017. The experimental (n = 102) and control (n = 149) groups were compared as to the rate of post-operative early returns. The influence of confounding factors was evaluated, including age, sex, body mass index (BMI), tobacco use, grade of medial femorotibial osteoarthritis (MFTO), magnitude of angular correction (MAC), and surgery duration.

Results

No statistically significant difference was found between the groups with regards to all variables except age. The experimental group was significantly older (54.4 years; σ = 7.5) than the control group (50.4 years; σ = 7.9; p < 0.001). We observed a decrease in emergency department (ED) visits in the experimental group (15.7%) compared to the control (30.2%; p = 0.008) and a decrease in early returns in the experimental group (28.4%) compared to the control (40.5%; p = 0.049). No statistically significant difference in demographic data, MFTO, or MAC was found among patients with and without an early return, in both the experimental and control groups.

Conclusion

The intrafocal injection of TXA during HTO decreases early returns to hospital.

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Acknowledgements

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. CHUM Research Centre, Centre de Recherche du Centre Hospitalier de l’Universite de Montreal, 1000, rue St- Denis, Montréal, Québec, H2X 0C1, Canada

    Julia Edward, Fidaa Al-Shakfa, Nicholas Newman & Frédéric Lavoie

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  1. Julia Edward
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  2. Fidaa Al-Shakfa
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  3. Nicholas Newman
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  4. Frédéric Lavoie
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Contributions

JE helped design the study, collected the data and wrote the manuscript. FA designed and performed the statistical analysis. NN reviewed the manuscript. FL conceived the study, supervised data collection and statistical analysis, and helped draft the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Julia Edward.

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Ethical approval

This retrospective study was performed in accordance with the ethical standards of the 1964 Declaration of Helsinki. The study was reviewed and approved by the ethics board of the Centre Hospitalier de l’Université de Montréal (CHUM) (registration number 21.377).

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Edward, J., Al-Shakfa, F., Newman, N. et al. Intrafocal injection of tranexamic acid decreases early return to hospital after high tibial osteotomy. Arch Orthop Trauma Surg (2024). https://doi.org/10.1007/s00402-024-05411-5

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