The advantages of using tranexamic acid in anterior cruciate ligament reconstruction: a randomized controlled trial




Milena Mikić, Department of Nursing, Faculty of Medicine, University of Novi Sad, Novi Sad; Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad; Serbia
Dragana Milutinović, Department of Nursing, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Branimirka Aranđelović, Department of Nursing, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
Nataša Stojaković, Department of Nursing, Faculty of Medicine, University of Novi Sad, Novi Sad; Department of Cardiovascular Surgery, Institute of Cardiovascular Diseases, Vojvodine, Sremska Kamenica; Serbia
Mirko Obradović, Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad, Serbia
Aleksandra Plećaš-Đurić, Department of Nursing, Faculty of Medicine, University of Novi Sad, Novi Sad;; Department of Anesthesia, Intensive Care and Pain Therapy, Clinical Center of Vojvodina, Novi Sad; Serbia
Predrag Rašović, Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad, Serbia
Miodrag Vranješ, Department of Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, Novi Sad;; Department of Surgery, University of Novi Sad, Faculty of Medicine, Novi Sad. Serbia


Objective: The number of participants in sports or some form of recreation globally has led to an increase in the incidence of anterior cruciate ligament (ACL) injuries and the number of surgeries performed. Although it does not belong to risky surgical interventions, this operation is accompanied by complications that slow down post-operative rehabilitation. The objective is to analyze the effects of intra-articular (IA) injection of tranexamic acid (TXA) on the reduction of post-operative drained blood volume, pain intensity, and incidence of hemarthrosis after ACL reconstruction. Methods: This prospective research included 124 patients undergoing ACL reconstruction surgery, randomly divided into two groups. The TXA group received IA TXA, whereas an equal amount of placebo was administered using the same route in the control group. Results: The research has shown that IA injection of TXA effectively reduces post-operative blood loss (TXA group 71.29 ± 40.76 vs. control group 154.35 ± 81.45), reducing the intensity of post-operative pain (p < 0.001) and the incidence of hemarthrosis. Conclusion: The application of TXA significantly reduced post-operative bleeding and pain intensity, which accelerated the post-operative period.



Keywords: Tranexamic acid. Anterior cruciate ligament reconstruction. Hemarthrosis. Intra-articular administration.