The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

Which Route of Tranexamic Acid Administration is More Effective to Reduce Blood Loss Following Total Knee Arthroplasty?

Document Type : RESEARCH PAPER

Authors
Sohrab Keyhani 1
Ali Akbar Esmailiejah 1
Mohammadreza Abbasian 1
Farshad Safdari 2
1 Orthopedic Surgeon, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Orthotist and Prosthetist, Bone Joint Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
10.22038/abjs.2016.5422
Abstract
 
Background: The most appropriate route of tranexamic acid administration is controversial. In the current study, we compared the efficacy of intravenous (IV) and topical intra-articular tranexamic acid in reducing blood loss and transfusion rate in patients who underwent primary total knee arthroplasty.

Methods: One hundred twenty 120 patients were scheduled to undergo primary total knee arthroplasty. Patients were randomly allocated to three equal groups: IV tranexamic acid (500 mg), topical tranexamic acid (3 g in 100 mL normal saline) and the control. In the topical group, half of the volume was used to irrigate the joint and the other half was injected intra-articularly. The volume of blood loss, hemoglobin (Hb) level at 24 hours postoperative, and rate of transfusion was compared between groups.

Results: The blood loss and Hb level were significantly greater and lower in the control group, respectively (P<0.05). Also, the rate of transfusion was significantly greater in the control group (P<0.05). However, IV and topical groups did not differ significantly in terms of measured variables. No patient experienced a thromboembolic event in our study.

Conclusion: Tranexamic acid is a useful antifibrinolytic drug to reduce postoperative blood loss, Hb drop, and rate of blood transfusion in patients undergoing total knee arthroplasty. The route of tranexamic acid administration did not affect the efficacy and safety.
Keywords
Blood loss
Blood transfusion
Hemoglobin
Total knee arthroplasty
Tranexamic acid
Route of administration
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The Archives of Bone and Joint Surgery
Volume 4, Issue 1 - Serial Number 1
January 2016
Pages 65-69

  • Receive Date 03 May 2015
  • Revise Date 21 August 2015
  • Accept Date 27 September 2015