The Role of Topically Administered Tranexamic Acid in Arthroplasty.

Code

J3-3067 (D) - included in ARIS records

Head

PhD Simon Kovač

Period

10/1/2021 - 9/30/2024

Range in 2023

0.21 FTE

Science

Natural sciences and mathematics (2)
Medical sciences (8)

Reseacher status

Researcher (10)
Junior expert or technical associate (0)

Education

Doctor's degree (8)
Other (2)

Sex

Woman (4)
Man (6)

Status

Employed at RO and RRD (9)
No data on employment in RO (1)

No. of publications

10–99 (4)
100–999 (6)

Projects / Programmes source: ARIS

source: ARIS

The Role of Topically Administered Tranexamic Acid in Arthroplasty.

Research activity

Code	Science	Field	Subfield
3.03.00	Medical sciences	Neurobiology

Code	Science	Field
3.01	Medical and Health Sciences	Basic medicine

Keywords

Tranexamic acid Topical use Intraarticular use Knee arthroplasty Hip arthroplasty Early postoperative infections Antibacterial action Cytotoxic action Anti-inflammatory action

Evaluation (rules)

source: COBISS

Evaluation of bibliographic research performance indicators according to ARIS methodology

Points

3,284.39

A''

79.7

A'

951.67

A1/2

1,867.21

CI10

5,276

CImax

235

h10

38

A1

10.7

A3

5.11

Data for the last 5 years (citations for the last 10 years) on April 18, 2024; A3 for period 2018-2022

Data for ARIS tenders ( 04.04.2019 – Programme tender, archive )

Citations Citations for bibliographic records in COBIB.SI that are linked to records in citation databases

source: WoS

source: Scopus

source: COBISS

Database	Linked records	Citations	Pure citations	Average pure citations
WoS	333	7,199	6,022	18.08
Scopus	358	8,436	7,145	19.96

Researchers (10)

no.	Code	Name and surname	Research area	Role	Period	No. of publicationsNo. of publications
1.	11308	PhD Andrej Cör	Oncology	Researcher	2021 - 2024	409
2.	23526	PhD Simon Kovač	Neurobiology	Head	2021 - 2024	183
3.	24220	PhD Vesna Levašič	Neurobiology	Researcher	2021 - 2024	159
4.	33035	PhD Rene Mihalič	Neurobiology	Researcher	2021 - 2024	113
5.	06013	PhD Damjana Rozman	Biochemistry and molecular biology	Researcher	2021 - 2024	887
6.	53940	Denia Savarin	Neurobiology	Researcher	2021 - 2024	26
7.	50455	PhD Cene Skubic	Biochemistry and molecular biology	Researcher	2021 - 2024	63
8.	54237	Urban Slokar	Neurobiology	Researcher	2021 - 2024	21
9.	35429	PhD Katja Šuster	Neurobiology	Researcher	2021 - 2024	38
10.	23524	PhD Rihard Trebše	Neurobiology	Researcher	2021 - 2024	426

Organisations (2)

no.	Code	Research organisation	City	Registration number	No. of publicationsNo. of publications
1.	0355	Orthopaedic Hospital Valdoltra	Ankaran	5053765	2,359
2.	0381	University of Ljubljana, Faculty of Medicine	Ljubljana	1627066	48,203

Abstract

The use of intravenously administered tranexamic acid (TXA) has been a well-known and established method of reducing perioperative blood loss and the need for allogeneic blood transfusion in the field of orthopedics. In addition to reducing blood loss, numerous studies have reported a lower incidence of early postoperative infections when using TXA. This observation was attributed to reduced blood transfusions and their immunomodulatory effects, beneficial effects on wound healing, and anti-inflammatory propertied of TXA. The efficacy and safety of intravenous TXA in arthroplasty have been confirmed by numerous meta-analyzes and clinical studies, while on the other hand there is little information available on the effects of topical TXA, which has been shown to be similarly effective in providing hemostasis. Due to the presumed lower risk of thromboembolic and other systemic side effects, intra-articular (i.a.) application of TXA is increasingly used, especially in arthroplasty. However, this mode of application remains controversial due to the confirmed cytotoxic effect of TXA on periarticular tissues, which increases with concentration of TXA and time of exposure. At the same time, actual local concentrations of TXA after i.a. application have not yet been researched; therefore, we do not know how long after i.a. application the concentrations in the periarticular hematoma are above the presumed cytotoxic threshold. There are also no known data on the possible cytotoxic effects of TXA on bacteria and its contribution on the observed lower incidence of early postoperative infections. In the case of topical application, where higher local concentrations are achieved, this potential effect is expected to be even greater than with IV application. In the proposed research project, designed from four working segments, we will measure the actual in vivo concentrations of TXA in the periarticular hematoma after standard i.a. application and explain the influence of topical TXA on the local immune response by measuring the concentrations of inflammatory cytokines in the periarticular hematoma. An in vitro experiment will be executed to evaluate the cytotoxic effect of TXA on the most common bacterial pathogens associated with early postoperative infections and elucidate its indirect effect on the incidence of early postoperative infections after arthroplasty. The effect of intra-articular TXA on the occurrence of surgical wound infections and early periprosthetic joint infections, together with the effect on perioperative blood loss and the need for blood transfusion, will additionally be examined by a retrospective cohort study. The research project will be carried out in cooperation of the Valdoltra Orthopedic Hospital Research group and the Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana. Majority of activities composing the project will be carried out at the Valdoltra Orthopedic Hospital, while the analysis of TXA and cytokine concentrations in the hematoma samples will be performed at the Institute of Biochemistry and Molecular Genetics.