Document Type : Review Article
Authors
1 Assistant Professor of Orthopaedics, Department of Orthopedics, School of Medicine,Tabriz University of Medical Sciences, Tabriz, Iran
2 Department of anesthesiology, Faculty of medicine, Tabriz medical sciences, Islamic Azad University, Tabriz, Iran
Abstract
Knee arthroplasty is a type of surgery that replaces the joint surface of the femur and leg bones in the knee joint with an artificial surface. Tranexamic acid binds to the binding sites of lysine in plasmin and plasminogen and thereby displaces plasminogen from the surface of fibrin and thus inhibits fibrinolysis. Local use of tranexamic acid can reduce bleeding in gynecological and obstetric surgeries, especially after delivery, urological surgery, oral surgery in hemophilia patients, and brain and spinal cord surgeries. Tranexamic acid is a plasminogen inhibitor and also inhibits urokinase activators. Tranexamic acid can be used orally and intravenously. Urokinase is a physiological thrombolytic agent that is produced in the kidney parenchymal cells and found in the urine. Urokinase binds directly to plasminogen and produces plasmin. Tranexamic acid is a synthetic derivative of the amino acid lysine and an antifibrinolytic agent that binds to plasminogen and prevents the interaction of plasminogen with fibrin and prevents fibrin clot dissolution. Urine and urothelium contain high concentrations of plasminogen activators. Tranexamic acid is used to reduce bleeding in heart surgeries, liver transplants, orthopedic surgeries, as well as in cases of arthroplasty and knee joint replacement, and to reduce bleeding after prostatectomy or tooth extraction. Also, this drug is used to treat idiopathic menorrhagia (20-23). Although prostate surgery is a very common surgery, little study was done on strategies to reduce the amount of transfusion, and there is still no universally accepted method.
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