Tranexamic acid decreases blood loss in patients undergoing TKA

Sarazeem MM. J Arthroplasty. 2014. doi10.1016/j.arth.2014.02.031.

Patients who received tranexamic acid when undergoing total knee arthroplasty experienced a decrease in blood loss and maintained a hemodynamically stable state, according to study results.

Researchers randomly assigned 200 patients who underwent unilateral knee arthroplasty (TKA) to receive 500 mg of tranexamic acid (TXA) in 100 cc of saline intravenously after closing the wound immediately (group 1); irrigation of the knee joint cavity with 3 g of TXA in 100 cc of saline before suturing (group 2); 1.5 g of TXA in 100 cc of saline injected through the Portovac drain immediately after wound closure (group 3); or no treatment with TXA (control group).

To estimate the postoperative blood loss and the difference in hemoglobin levels between the preoperative and postoperative lowest levels, the researchers recorded the amount of drainage from each patient and measured hemoglobin preoperatively and at 6, 24 and 48 hours postoperatively.

By 48 hours postoperatively, patients who received TXA had a significantly diminished volume of mean discharge compared with the control group, according to the researchers. Blood loss was also significantly lower in TXA groups, with less blood loss found among patients who received intra-articular administration of TXA compared with intravenous injection, and less blood loss through intravenous administration compared with irrigation of the knee joint with TXA. Compared with the control group, the researchers found a significantly lower hemoglobin drop among patients who received TXA.

Disclosure: The authors have no relevant financial disclosures.


Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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