{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:03:20Z","timestamp":1783479800067,"version":"3.55.0"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T00:00:00Z","timestamp":1672099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004829","name":"Department of Science and Technology of Sichuan Province","doi-asserted-by":"publisher","award":["2020YFS0139"],"award-info":[{"award-number":["2020YFS0139"]}],"id":[{"id":"10.13039\/501100004829","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>There were limited randomized controlled trials (RCTs) of epsilon\u2010aminocaproic acid (EACA) versus tranexamic acid (TXA) in total knee arthroplasty (TKA). The aim of the study was to compare the efficacy and safety of TXA and EACA in the combination of intravenous (IV) and intra\u2010articular (IA) administration on reducing blood loss in patients following primary TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 2020 to January 2021, a total of 181 patients undergoing a primary unilateral TKA were enrolled in this prospective randomized controlled trial. Patients in the TXA group (<jats:italic>n<\/jats:italic>\u00a0=\u00a090) received 20\u2009mg\/kg of intravenous TXA preoperatively, 1\u2009g of intra\u2010articular TXA intraoperatively, and three doses of 20\u2009mg\/kg intravenous TXA at 0, 3, 6\u2009h postoperatively. Patients in the EACA group (<jats:italic>n<\/jats:italic>\u00a0=\u00a091) received 120\u2009mg\/kg of intravenous EACA preoperatively, 2\u2009g of intra\u2010articular EACA intraoperatively, and three doses of 40\u2009mg\/kg intravenous EACA at 0, 3, 6\u2009h postoperatively. The primary outcomes were total blood loss (TBL), transfusion rates and drop of hemoglobin (HB) level. The secondary outcomes included postoperative hospital stays and postoperative complications. The chi\u2010square tests and Fisher's exact tests were utilized to compare categorical variables, while the independent\u2010samples <jats:italic>t<\/jats:italic>\u2010tests and Mann\u2013Whitney tests were used to compare continuous variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The patients who received TXA averaged less TBL than the patients who received EACA (831.83\u2009ml <jats:italic>vs<\/jats:italic> 1065.49\u2009ml, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.015), and HB drop in TXA group was generally less than that of EACA group on postoperative day 1 and 3 (20.84\u2009\u00b1\u20099.48\u2009g\/L <jats:italic>vs<\/jats:italic> 24.99\u2009\u00b1\u20099.40\u2009g\/L, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.004; 31.28\u2009\u00b1\u200911.19 <jats:italic>vs<\/jats:italic> 35.46\u2009\u00b1\u200912.26\u2009g\/L, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.047). The length of postoperative stays in EACA group was 3.66\u2009\u00b1\u20090.81\u00a0day, which is longer than 2.62\u2009\u00b1\u20090.68\u00a0day in TXA group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). No transfusions were required in either group. The risk of nausea and vomiting in TXA group was significantly higher than that in EACA group (11\/90 <jats:italic>vs<\/jats:italic> 0\/91, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although the TBL and HB drop were slightly greater in EACA group, these results were not clinically important, given that no transfusions were required. EACA could be an alternative to TXA, especially for patients with severe nausea and vomiting after using TXA postoperatively. Further studies are needed to adjust dosage of EACA to make better comparison of the two drugs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13638","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T06:14:10Z","timestamp":1672208050000},"page":"687-694","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Combination of Intravenous and Intra\u2010Articular Application of Tranexamic Acid and Epsilon\u2010Aminocaproic Acid in Primary Total Knee Arthroplasty: A Prospective Randomized Controlled Trial"],"prefix":"10.1111","volume":"15","author":[{"given":"Che","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Orthopaedics West China Hospital, Sichuan University  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics West China Hospital, Sichuan 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