The effect of single dose, preoperative intravenous tranexamic acid on early postoperative pain scores after rotator cuff repair: a double blind, randomized control trial

Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores. A randomi...

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Published inJournal of shoulder and elbow surgery
Main Authors Mackenzie, Samuel P, Spasojevic, Miloš, Smith, Margaret, Mattern, Owen, Piggott, Robert P, Patel, Shaan S, Bedaiwy, Najla, Cass, Benjamin, Young, Allan
Format Journal Article
LanguageEnglish
Published United States 25.03.2022
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Abstract Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores. A randomized double-blind trail was conducted in 89 patients undergoing RCR. Patients were randomized to either 2g of intravenous TXA or placebo at induction. The primary outcome was VAS-pain score at day three postoperative with secondary outcomes including VAS-pain, ASES and Constant Score at two weeks, eight weeks, 24 weeks and 52 weeks. There was no significant difference in VAS-pain between groups at day three postoperative. Pain scores were statistically better in the TXA group at 8 weeks. There was no difference between groups at any time point in the ASES or Constant score. The TXA group had improved motion at six months with a reduced rate of secondary adhesive capsulitis. TXA did not improve postoperative pain scores after RCR, however, patients who received the intervention demonstrated greater range of movement at six months with lower rates of secondary adhesive capsulitis.
AbstractList Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in rotator cuff repair (RCR) surgery is less defined. This trial assessed the effect of preoperative TXA on early postoperative pain scores. A randomized double-blind trail was conducted in 89 patients undergoing RCR. Patients were randomized to either 2g of intravenous TXA or placebo at induction. The primary outcome was VAS-pain score at day three postoperative with secondary outcomes including VAS-pain, ASES and Constant Score at two weeks, eight weeks, 24 weeks and 52 weeks. There was no significant difference in VAS-pain between groups at day three postoperative. Pain scores were statistically better in the TXA group at 8 weeks. There was no difference between groups at any time point in the ASES or Constant score. The TXA group had improved motion at six months with a reduced rate of secondary adhesive capsulitis. TXA did not improve postoperative pain scores after RCR, however, patients who received the intervention demonstrated greater range of movement at six months with lower rates of secondary adhesive capsulitis.
Author Cass, Benjamin
Mackenzie, Samuel P
Piggott, Robert P
Bedaiwy, Najla
Mattern, Owen
Young, Allan
Spasojevic, Miloš
Patel, Shaan S
Smith, Margaret
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  surname: Spasojevic
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  email: milos.spasojevic.ortho@gmail.com
  organization: Sydney Shoulder Research Institute, Suite 201, 156 Pacific Highway, St Leonards 2065, Australia. Electronic address: milos.spasojevic.ortho@gmail.com
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  organization: Sydney Shoulder Research Institute, Suite 201, 156 Pacific Highway, St Leonards 2065, Australia
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Keywords capsulitis
shoulder surgery
Tranexamic acid
arthroscopic rotator cuff repair
txa
Language English
License Copyright © 2022. Published by Elsevier Inc.
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PublicationTitle Journal of shoulder and elbow surgery
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Snippet Tranexamic acid (TXA) is commonly used in upper and lower limb arthroplasty to limit blood loss and postoperative hematoma formation. The role of TXA in...
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Title The effect of single dose, preoperative intravenous tranexamic acid on early postoperative pain scores after rotator cuff repair: a double blind, randomized control trial
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