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Osteoarthritis, KneeNCT03954860

Effect of no Drainage Tube on Blood Loss and Recovery After High Tibial Osteotomy

A study testing Drainage Tube, Tranexamic Acid and Sodium Chloride 0.9% in people with Osteoarthritis, Knee, run by Qilu Hospital of Shandong University at 1 site in China.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study was to evaluate the safety and efficacy of topical combined with intravenous tranexamic acid for high tibial osteotomy without placement of a drainage tube The clinical scores of patients and their possible risks were tracked. Read more about this study

Who is it for?
Any age
Conditions the study is for
Osteoarthritis, Knee
What is being tested?
Drainage Tube, Tranexamic Acid and Sodium Chloride 0.9%
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteChina
Study dates
1 Aug 2018to 1 Sep 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Simple knee medial compartment osteoarthritis High tibial osteotomy.
  • With varus deformity, medial proximal tibia angle <85°
  • Unilateral High tibial osteotomy
  • informed consent: Participants must be able to understand and voluntarily sign a written informed consent and follow the research protocol and interview process

Who cannot join

  • patients who underwent other knee surgery within 6 months
  • Preoperative combined anemia (Hb<100g/l)
  • Patients with severe cardiovascular, hepatic, renal and hematopoietic diseases
  • Patient with preoperative coagulation abnormalities 5. Patients with allergies and patients allergic to TXA.

Trial locations and contacts

1 site in 1 country.

China1 site
  • Qilu hospital of Shandong University

    Jinan, Shandong, 250014

Other trials in China

About this study

The objective of this study was to evaluate the safety and efficacy of topical combined with intravenous tranexamic acid for high tibial osteotomy without placement of a drainage tube The clinical scores of patients and their possible risks were tracked. The investigators hypothesized that a combination of tranexamic acid and no drainage tube could reduce blood loss and facilitate early recovery. The implementation of the study will provide a new perioperative blood loss control program for High Tibial Osteotomy, reduce the cost of hospitalization, promote patients to get out of bed early, reduce the number of days in hospital.

Read the detailed description

The condition of the patients was evaluated, and the total length of both lower limbs, anteroposterior position of knee and Mri of knee were included. The preoperative dose of tranexamic acid was calculated according to body weight of 20 mg / kg, 100 ml of tranexamic acid sodium chloride solution was dripped 30 minutes before operation, and after incision closure, 30 ml of normal saline solution containing 2 g of tranexamic acid was injected through drainage tube or subcutaneously. Postoperative intravenous drip of 100 ML sodium chloride solution containing 20 mg / kg tranexamic acid. Arthroscopy was first used to further confirm the cartilage defect, and a new type of lower limb alignment meter and a customized precise osteotomy template were used to perform the osteotomy according to the preoperative plan. One group was not placed drainage tube, the other group was placed drainage tube. Visual analogue pain score (Vas) and American Special Surgical Hospital (HSS) knee function score were recorded 3 month after surgery. Throughout the trial, the investigators will carefully observe and manage your complications and the outcome of your surgery.

Being tested
Drainage Tube, Tranexamic Acid, Sodium Chloride 0.9%
Medical subject headings
Osteoarthritis, Knee

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Drainage TubeOther

    The drainage tube drainage to guide the pus, blood and liquid accumulated between human tissues or in body cavity outside the body of High tibial osteotomy'patients.

  • Tranexamic AcidDrug

    Also called TXA

    Tranexamic acid (TXA) is an anti-fibrinolytic drugcan,which can increase the stability of fibrin clots and achieve hemostasis for High tibial osteotomy'patients.

  • Sodium Chloride 0.9%Drug

    Also called sodium chloride solution

    Sodium Chloride 0.9% is a solution of sodium chloride, which has the same osmotic pressure as animal or human plasma in physiological experiments or clinics, and can be used to dilute Tranexamic Acid .

Study groups in NCT03954860
Study groupRoleWhat they receive
No DrainageExperimentalThe preoperative dose of tranexamic acid was calculated according to 20 mg / kg body weight, 100 ml of tranexamic acid sodium chloride solution was dripped 30 minutes before operation, and 30 ml saline containing 2 g tranexamic acid was applied to the local area before loosening the tourniquet.Postoperative intravenous drip of 100 ML sodium chloride solution containing 20 mg / kg tranexamic acid. No drainage tube was placed after operation.
Receives: Drug: Tranexamic Acid; Drug: Sodium Chloride 0.9%
DrainageActive comparatorThe preoperative dose of tranexamic acid was calculated according to 20 mg / kg body weight, 100 ml of tranexamic acid sodium chloride solution was dripped 30 minutes before operation, and 30 ml saline containing 2 g tranexamic acid was applied to the local area before loosening the tourniquet.Postoperative intravenous drip of 100 ML sodium chloride solution containing 20 mg / kg tranexamic acid. Drainage tube should be placed after operation.
Receives: Other: Drainage Tube; Drug: Tranexamic Acid; Drug: Sodium Chloride 0.9%

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Postoperative blood loss

    Total blood loss preoperative blood volume =(preoperative hematocrit-postoperative Hematocrit) + transfusion volume.

    Measured: The third day after operation

  2. Haemoglobin

    Reactive blood loss

    Measured: The third day after operation

  3. Hematocrit

    Reactive blood loss

    Measured: The third day after operation

  4. Hospital for special surgery knee score

    HSS is a knee function scoring system with a full score of 100. 0 means the loss of knee function, 100 means the best knee function, and the greater the value, the better knee function.

    Measured: postoperative 3 month

  5. Visual Analogue Scale Postoperative Day One

    Draw a 10 cm horizontal line on the paper. One end of the line is 0, indicating no pain; the other end is 10, indicating severe pain; and the middle part indicates varying degrees of pain. The patient selects a point from the horizontal line and the length from 0 to this point is the Visual Analogue Scale score.

    Measured: Postoperative Day One

  6. Visual Analogue Scale Postoperative Day Three

    Draw a 10 cm horizontal line on the paper. One end of the line is 0, indicating no pain; the other end is 10, indicating severe pain; and the middle part indicates varying degrees of pain. The patient selects a point from the horizontal line and the length from 0 to this point is the Visual Analogue Scale score.

    Measured: Postoperative Day Three

  7. Visual Analogue Scale Postoperative Day Five

    Draw a 10 cm horizontal line on the paper. One end of the line is 0, indicating no pain; the other end is 10, indicating severe pain; and the middle part indicates varying degrees of pain. The patient selects a point from the horizontal line and the length from 0 to this point is the Visual Analogue Scale score.

    Measured: Postoperative Day Five

  8. Circumference of shank Postoperative Day One

    indirectly reflects the latent blood loss

    Measured: Postoperative Day One

  9. Circumference of shank Postoperative Day Three

    indirectly reflects the latent blood loss

    Measured: Postoperative Day Three

  10. Circumference of shank Postoperative Day Five

    indirectly reflects the latent blood loss

    Measured: Postoperative Day Five

  11. Number of blood transfusions

    If the hemoglobin was <80 g/l, allogeneic blood was transfused, and the number of blood transfusions were recorded.0 means no blood transfusion, and the larger the number is, the more blood transfusion.The maximum number does not exceed the total number of patients

    Measured: Postoperative Day Three

  12. Number of Incision infection

    The incision was red, swollen, hot and painful, and the blood routine showed that the leukocyte was increased.

    Measured: postoperative 3 month

  13. Number of hematoma formation

    After operation, the incision is swollen and has wave motion, but it is not hot or painful, and there will be blood outflow during puncture.

    Measured: postoperative 3 month

  14. Number of delayed healing of the incision.

    On the 14th day after operation, the incision did not heal.

    Measured: On the 14th day after operation

  15. Volume of drainage

    Reactive blood loss

    Measured: Postoperative Day One

Secondary outcomes (4)
  1. Activated partial thromboplastin time

    Assessment of coagulation function in patients

    Measured: The third day after operation

  2. Prothrombin time

    Assessment of exogenous coagulation system

    Measured: The third day after operation

  3. Concentration of D-dimer

    Assessment of thrombotic diseases

    Measured: The third day after operation

  4. Concentration of Fibrinogen

    Assessment of coagulation function in patients

    Measured: The third day after operation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 May 2019
  2. Study start1 Aug 2018
  3. Primary completion1 Sep 2019
  4. Study completion1 Sep 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
80 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03954860
Sponsor's protocol ID
2019041
Status last verified
May 2019
First submitted
6 May 2019
Last updated
19 Feb 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The datasets used and/or analysed during the current study are available from the overall study officials on reasonable request.

Publications

  • Kim KI, Kim HJ, Kim GB, Bae SH. Tranexamic acid is effective for blood management in open-wedge high tibial osteotomy. Orthop Traumatol Surg Res. 2018 Nov;104(7):1003-1007. doi: 10.1016/j.otsr.2018.07.019. Epub 2018 Sep 20.

    PubMed 30245067
  • Palanisamy JV, Das S, Moon KH, Kim DH, Kim TK. Intravenous Tranexamic Acid Reduces Postoperative Blood Loss After High Tibial Osteotomy. Clin Orthop Relat Res. 2018 Nov;476(11):2148-2154. doi: 10.1097/CORR.0000000000000378.

    PubMed 29939895
  • Suh DW, Kyung BS, Han SB, Cheong K, Lee WH. Efficacy of Tranexamic Acid for Hemostasis in Patients Undergoing High Tibial Osteotomy. J Knee Surg. 2018 Jan;31(1):50-55. doi: 10.1055/s-0037-1600091. Epub 2017 Mar 29.

    PubMed 28355682
  • Zhang Q, Zhang Q, Guo W, Liu Z, Cheng L, Zhu G. No need for use of drainage after minimally invasive unicompartmental knee arthroplasty: a prospective randomized, controlled trial. Arch Orthop Trauma Surg. 2015 May;135(5):709-13. doi: 10.1007/s00402-015-2192-z. Epub 2015 Mar 8.

    PubMed 25750137
  • Huang Z, Xie X, Li L, Huang Q, Ma J, Shen B, Kraus VB, Pei F. Intravenous and Topical Tranexamic Acid Alone Are Superior to Tourniquet Use for Primary Total Knee Arthroplasty: A Prospective, Randomized Controlled Trial. J Bone Joint Surg Am. 2017 Dec 20;99(24):2053-2061. doi: 10.2106/JBJS.16.01525.

    PubMed 29257010
  • Chan JJ, Cirino CM, Huang HH, Poeran J, Mazumdar M, Parsons BO, Anthony SG, Galatz LM, Cagle PJ Jr. Drain Use is Associated with Increased Odds of Blood Transfusion in Total Shoulder Arthroplasty: A Population-Based Study. Clin Orthop Relat Res. 2019 Jul;477(7):1700-1711. doi: 10.1097/CORR.0000000000000728.

    PubMed 30985612
  • Legnani C, Oriani G, Parente F, Ventura A. Reducing transfusion requirements following total knee arthroplasty: effectiveness of a double infusion of tranexamic acid. Eur Rev Med Pharmacol Sci. 2019 Mar;23(5):2253-2256. doi: 10.26355/eurrev_201903_17273.

    PubMed 30915773
  • Nishitani K, Kuriyama S, Nakamura S, Ito H, Matsuda S. A Multivariate Analysis on the Effect of No Closed Suction Drain on the Length of Hospital Stay in Total Knee Arthroplasty. Knee Surg Relat Res. 2019 Mar 1;31(1):25-30. doi: 10.5792/ksrr.18.013.

    PubMed 30871289
  • Li S, Yang J, Watson C, Lu Q, Zhang M, Miao Z, Luo D, Liu P. Drainage relieves pain without increasing post-operative blood loss in high tibial osteotomy: a prospective randomized controlled study. Int Orthop. 2020 Jun;44(6):1037-1043. doi: 10.1007/s00264-020-04530-z. Epub 2020 Mar 14.

    PubMed 32172314

Questions about this trial

What is this clinical trial studying?

A study testing Drainage Tube, Tranexamic Acid and Sodium Chloride 0.9% in people with Osteoarthritis, Knee, run by Qilu Hospital of Shandong University at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Feb 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Postoperative blood loss (time frame: The third day after operation). The study lists 15 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03954860, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Feb 2020.

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