{"id":11572,"date":"2025-04-30T23:41:15","date_gmt":"2025-04-30T21:41:15","guid":{"rendered":"https:\/\/cepco-ch-123278.hostingersite.com\/publications\/a-single-dose-of-tranexamic-acid-reduces-blood-loss-after-reverse-and-anatomic-shoulder-arthroplasty-a-randomized-controlled-trial\/"},"modified":"2026-04-25T19:52:29","modified_gmt":"2026-04-25T17:52:29","slug":"a-single-dose-of-tranexamic-acid-reduces-blood-loss-after-reverse-and-anatomic-shoulder-arthroplasty-a-randomized-controlled-trial","status":"publish","type":"publications","link":"https:\/\/cepco.ch\/fr\/publications\/a-single-dose-of-tranexamic-acid-reduces-blood-loss-after-reverse-and-anatomic-shoulder-arthroplasty-a-randomized-controlled-trial\/","title":{"rendered":"A single dose of tranexamic acid reduces blood loss after reverse and anatomic shoulder arthroplasty: a randomized controlled trial"},"content":{"rendered":"\n<p><strong>Publication :<\/strong> <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/33421559\/\" target=\"_blank\" rel=\"noreferrer noopener\">J Shoulder Elbow Surg. 2021 Jul;30(7):1553-1560. doi : 10.1016\/j.jse.2020.11.022. Epub 2021 Jan 6.  <\/a><\/p>\n\n<p><strong>Co-auteurs :<\/strong> <a href=\"https:\/\/cepco.ch\/biography-of-dr-gregory-cunningham\/\" target=\"_blank\" rel=\"noreferrer noopener\">Cunningham G<\/a>, Hughes J, Borner B, et al.<\/p>\n\n<h2 class=\"wp-block-heading\">R\u00e9sum\u00e9 :<\/h2>\n\n<p><strong>Contexte : <\/strong>La formation d&rsquo;h\u00e9matomes et la n\u00e9cessit\u00e9 de transfusions sanguines sont des complications fr\u00e9quemment signal\u00e9es apr\u00e8s une arthroplastie de l&rsquo;\u00e9paule. L&rsquo;acide tranexamique (TXA) a \u00e9t\u00e9 largement utilis\u00e9 dans l&rsquo;arthroplastie de la hanche et du genou pour r\u00e9duire les pertes sanguines p\u00e9riop\u00e9ratoires. Le r\u00f4le du TXA est encore en cours d&rsquo;\u00e9tablissement dans l&rsquo;arthroplastie de l&rsquo;\u00e9paule.  <\/p>\n\n<p><strong>Mat\u00e9riels et m\u00e9thodes : <\/strong>Nous avons r\u00e9alis\u00e9 un essai contr\u00f4l\u00e9 randomis\u00e9 en double aveugle comparant le TXA intraveineux au placebo chez 60 patients b\u00e9n\u00e9ficiant d&rsquo;une arthroplastie primaire anatomique ou invers\u00e9e de l&rsquo;\u00e9paule. Parmi ces patients, 29 ont re\u00e7u un placebo tandis que 31 ont re\u00e7u une dose unique de 2 g de TXA intraveineux. Les caract\u00e9ristiques d\u00e9mographiques des patients, ainsi que le d\u00e9bit du tube de drainage, la perte de sang, la formation d&rsquo;h\u00e9matomes, les besoins en transfusion, la dur\u00e9e du s\u00e9jour \u00e0 l&rsquo;h\u00f4pital et le score de douleur ont \u00e9t\u00e9 enregistr\u00e9s. Les patients ont \u00e9t\u00e9 suivis pendant 12 semaines pour \u00e9valuer les complications.   <\/p>\n\n<p><strong>R\u00e9sultats : <\/strong>Les patients qui ont re\u00e7u du TXA ont eu un d\u00e9bit de tube de drainage plus faible \u00e0 tous les points dans le temps : 41 ml contre 133 ml \u00e0 6 heures, 75 ml contre 179 ml \u00e0 12 heures et 94 ml contre 226 ml \u00e0 24 heures (P &lt;.001 pour tous). Ils avaient \u00e9galement un taux d&rsquo;h\u00e9moglobine (Hb) postop\u00e9ratoire plus \u00e9lev\u00e9 (12,3 g\/dL vs. 11,4 g\/dL, P = .009), une variation plus faible du taux d&rsquo;Hb (1,7 g\/dL vs. 2,3 g\/dL, P = .011), une perte d&rsquo;Hb totale plus faible (0,078 g vs. 0.103 g, P = .042), une perte de volume sanguin plus faible (0,55 L vs. 0,74 L, P = .021), un taux d&rsquo;h\u00e9matocrite postop\u00e9ratoire plus \u00e9lev\u00e9 (36,7 % vs. 34,6 %, P = .020), et un changement d&rsquo;h\u00e9matocrite plus faible (5,4 % vs. 7,6 %, P = .022). Il n&rsquo;y a pas eu de diff\u00e9rence significative dans le score de douleur ou la dur\u00e9e du s\u00e9jour \u00e0 l&rsquo;h\u00f4pital, et aucun patient n&rsquo;a eu besoin d&rsquo;une transfusion.  <\/p>\n\n<p><strong>Conclusion : <\/strong>Une dose unique de 2 g de TXA intraveineux diminue la perte de sang et le d\u00e9bit du tube de drainage dans l&rsquo;arthroplastie primaire anatomique et invers\u00e9e de l&rsquo;\u00e9paule. Aucune diff\u00e9rence n&rsquo;a \u00e9t\u00e9 d\u00e9tect\u00e9e dans la survenue de complications, le besoin de transfusion, le score de douleur ou la dur\u00e9e du s\u00e9jour \u00e0 l&rsquo;h\u00f4pital. Compte tenu des preuves de plus en plus nombreuses, les patients subissant une arthroplastie primaire \u00e9lective de l&rsquo;\u00e9paule devraient recevoir de la TXA par voie intraveineuse afin de r\u00e9duire les pertes sanguines p\u00e9riop\u00e9ratoires.  <\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false,"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}}},"publication_categories":[151,176],"class_list":["post-11572","publications","type-publications","status-publish","hentry","publication_categories-publications-scientifiques","publication_categories-scientific-publications"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.9 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>A single dose of tranexamic acid reduces blood loss after reverse and anatomic shoulder arthroplasty: a randomized controlled trial - CEPCO - Centre Epaule Coude<\/title>\n<meta name=\"description\" content=\"Medline Indexed (Pubmed) - Shoulder arthroplasty; 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