Evaluation of Antifibrinolytic Use in Anterior Cruciate Ligament Arthroscopic Reconstruction. A Prospective Clinical Trial

Objective. To evaluate the effectiveness of two antifibrinolytic drugs (tranexamic acid and epsilon-aminocaproic acid) in reducing postoperative hemarthrosis after anterior cruciate ligament reconstruction. Methods. 45 patients diagnosed with primary anterior cruciate ligament tears were randomly placed into 3 groups: control, tranexamic acid (TXA) and epsilon-aminocaproic acid (EAC). The first group was operated on without the use of the drugs, and for the other two, the dose was adjusted by weight. The evaluation was conducted for 1 and 7 postoperative days to assess the degree of hemarthrosis, assess the visual pain scale and measure the range of motion (ROM) in degrees. The patients were then assigned a subjective functional score at 14 and 28 postoperative days. Results. The TXA group showed improvement on the postoperative pain scale after 7 days compared to the control group. When evaluated with the Lysholm functional score, the TXA group showed improvement compared to the control group. No significant statistical difference emerged in the parameter evaluated for the EAC group. Conclusions. The tranexamic-acid group showed reduced pain and improved function after arthroscopic reconstruction of the ACL. Up to this point, the use of Epsilon-aminocaproic acid yielded no benefit. A follow-up study with more participants may confirmation our findings or present new relevant findings.