{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T08:02:34Z","timestamp":1767772954909},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"05","funder":[{"name":"Post-Doctor Research Project, West China Hospital, Sichuan University","award":["2018HXBH073"],"award-info":[{"award-number":["2018HXBH073"]}]},{"name":"National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University","award":["Z2018B11"],"award-info":[{"award-number":["Z2018B11"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The optimal regimes of tranexamic acid (TXA) and dexamethasone (DXM) in total knee arthroplasty (TKA) are still uncertain. The aim of this study was to assess the efficacy and safety of a prolonged course of intravenous TXA and DXM involving a high initial dose in TKA. Patients who underwent primary TKA at our center were randomized to receive one of four regimes: control (group A), prolonged course of TXA (B), prolonged course of DXM (C), or the combination of a prolonged course of TXA and DXM (D). The four groups were compared in primary outcomes (fibrinolytic and inflammatory markers, knee function, postoperative pain levels, and consumption of opioids) and secondary outcomes (blood loss, maximal drop in hemoglobin, coagulation, fasting blood glucose, and complications). A total of 162 patients were enrolled. On postoperative days 2 and 3, fibrinolytic markers were lower in groups B and D than in groups A and C; inflammatory markers were lower in groups C and D than in groups A and B. Inflammatory markers were lower in group B than in group A on postoperative day 3. Postoperative pain levels and oxycodone consumption were lower, and knee function was better in groups C and D. The four groups did not differ in any of the secondary outcomes. A prolonged course of intravenous TXA and DXM involving high initial doses can effectively inhibit postoperative fibrinolytic and inflammatory responses, reduce pain, and improve knee function after TKA.<\/jats:p>","DOI":"10.1055\/s-0041-1739197","type":"journal-article","created":{"date-parts":[[2021,11,18]],"date-time":"2021-11-18T23:46:38Z","timestamp":1637279198000},"page":"515-523","source":"Crossref","is-referenced-by-count":4,"title":["Synergistic Effect of a Prolonged Combination Course of Tranexamic Acid and Dexamethasone Involving High Initial Doses in Total Knee Arthroplasty: A Randomized Controlled Trial"],"prefix":"10.1055","volume":"36","author":[{"given":"Hong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinwei","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingli","family":"Yang","sequence":"additional","affiliation":[{"name":"College of Earth and Environmental Sciences and School of Public Health, Lanzhou University, Lanzhou, Gansu, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Duan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuxing","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Sichuan, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,11,18]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1177\/1076029615611251","article-title":"Perioperative factors and their effect on the fibrinolytic system in arthroplasty patients","volume":"22","author":"A Burleson","year":"2016","journal-title":"Clin Appl Thromb Hemost"},{"issue":"11","key":"ref2","doi-asserted-by":"crossref","first-page":"2458","DOI":"10.1016\/j.arth.2016.04.034","article-title":"Multiple boluses of intravenous tranexamic acid to reduce hidden blood loss after primary total knee arthroplasty without tourniquet: a randomized clinical trial","volume":"31","author":"J 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