Our Summary

This paper is about the use of a medicine called Tranexamic acid (TXA) in orthopedic sports medicine, specifically in arthroscopic surgery, a minimally invasive procedure used to treat problems in joints. TXA is known to reduce the risk of complications related to bleeding in the joint after surgery. It has been widely studied and used in other types of orthopedic surgery, such as joint replacements, trauma surgery, and spine surgery, but there hasn’t been much investigation into its use in sports medicine procedures. There’s a lack of high-quality studies that either support or refute its use in common orthopedic surgeries. The paper suggests that TXA might have a small benefit in specific surgeries like partial meniscectomy (removal of a part of the knee cartilage) or anterior cruciate ligament reconstruction (a surgery to repair a torn ligament in the knee). Even though there might be some risks or side effects associated with TXA, these are very low, just like its cost. Therefore, even a small benefit could make it worthwhile to use.

FAQs

  1. What is Tranexamic acid (TXA) and what is it used for in orthopaedic surgery?
  2. What potential benefits does TXA offer in routine partial meniscectomy or anterior cruciate ligament reconstruction?
  3. What are the potential risks and side effects of using TXA in orthopaedic surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about shoulder replacement is to discuss the option of using tranexamic acid (TXA) during the surgery. TXA is an antifibrinolytic medication that can help reduce the risk of bleeding and related complications during and after the surgery. While more research is needed on its use in orthopaedic sports medicine, TXA has been shown to be beneficial in other orthopaedic surgeries. It is a low-cost medication with minimal side effects, so it may be worth considering as part of the treatment plan for shoulder replacement surgery.

Suitable For

Patients who are typically recommended for shoulder replacement surgery are those who have severe shoulder pain and loss of function due to conditions such as osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. Other factors that may indicate the need for shoulder replacement include failed previous conservative treatments, such as physical therapy, medications, and injections, as well as the presence of significant joint deformity or instability.

Additionally, patients who have tried other surgical procedures, such as arthroscopic shoulder surgery, and have not experienced significant improvement in their symptoms may also be candidates for shoulder replacement. It is important for patients to undergo a thorough evaluation by an orthopaedic surgeon to determine if shoulder replacement is the most appropriate treatment option for their specific condition.

Timeline

Before shoulder replacement surgery:

  • Patient experiences chronic shoulder pain, stiffness, and limited range of motion
  • Patient undergoes diagnostic tests such as X-rays, MRI, and physical examination to determine the extent of damage to the shoulder joint
  • Orthopedic surgeon recommends shoulder replacement surgery as a treatment option
  • Preoperative assessments and consultations are conducted to ensure patient is a suitable candidate for surgery

After shoulder replacement surgery:

  • Patient undergoes the surgical procedure to replace damaged shoulder joint with an artificial implant
  • Postoperative care includes pain management, physical therapy, and monitoring for complications such as infection or dislocation
  • Patient gradually regains strength and range of motion in the shoulder through rehabilitation exercises
  • Follow-up appointments with the orthopedic surgeon are scheduled to monitor healing progress and address any concerns
  • Patient returns to normal activities with reduced pain and improved shoulder function

What to Ask Your Doctor

  1. How will a shoulder replacement improve my range of motion and reduce pain?
  2. What are the potential risks and complications associated with shoulder replacement surgery?
  3. What is the expected recovery time and rehabilitation process after shoulder replacement surgery?
  4. Are there any alternative treatment options to shoulder replacement that I should consider?
  5. How long can I expect the shoulder replacement to last before needing a revision surgery?
  6. Will I need physical therapy after shoulder replacement surgery, and if so, for how long?
  7. What restrictions or limitations should I expect after shoulder replacement surgery?
  8. What is the success rate of shoulder replacement surgery in patients with similar conditions to mine?
  9. Are there any specific lifestyle modifications or precautions I should take after shoulder replacement surgery?
  10. How often should I follow up with you after the surgery, and what signs or symptoms should I watch out for that may indicate a complication?

Reference

Authors: Alaia MJ, Gipsman AM. Journal: Arthroscopy. 2021 Apr;37(4):1334-1336. doi: 10.1016/j.arthro.2021.01.027. PMID: 33812531