Intravenous use of tranexamic acid reduces postoperative blood loss in total knee arthroplasty
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Blood transfusion is often required in total knee replacement (TKR); several methods of blood preservation are commonly used but the ideal solution is to reduce the blood loss during and after surgery. Aim of the study was to evaluate the hemostatic efficacy and safety of intravenous use of tranexamic acid in patients receiving TKR (cemented).
Materials and methods
Forty-five patients after TKR receive treatment with tranexamic acid (TXA, treatment group), and 45 were managed with fibrin tissue adhesive (control group). Hemoglobin values decrease and transfusions in both groups were recorded. Statistical analysis was performed with Student t test and χ 2 test. A statistical model was elaborated to evaluate together all variables and to underline what data can increase transfusions need.
A significant reduction was detected in hemoglobin values in the first 3 days after surgery in the treatment group. The difference in all cases was significant. When tranexamic acid was administered, the need for transfusions was lower (difference statistically significant). No major adverse events were recorded in our series. The use of autologous blood preparation before surgery led to a higher transfusion rate.
Tranexamic acid reduced blood loss in TKR and significantly reduced the blood transfusion need also when compared to fibrin tissue adhesive. The use of tranexamic acid is safe and in future may avoid preparation of autologous blood unit before surgery with a decrease of cost and medical figures involved.
KeywordsTranexamic acid Total knee replacement Fibrin sealant Blood transfusions
Conflict of interest
- 4.Everts PA, Davilee RJ, Oosterbos CJ (2007) Autologous platelet gel and fibrin sealant enhance the efficacy of total knee arthroplasty: improved range of motion, decreased length of stay and a reduced incidence of arthrofibrosis. Knee Surg Sports Traumatol Arthrosc 15(7):888–894PubMedCrossRefGoogle Scholar
- 6.Flynn JC, Csenesitz TA (1979) Present status of intraoperative blood recovery during orthopaedics surgery. Jefferson Orthop J 8:22–25Google Scholar
- 8.Spahn DR, Casutt M (2012) Eliminated blood transfusion: new aspects and perspectives. Anestesiology 13(3):145–151Google Scholar
- 12.Blackwell Science Ltd (2000) Guidelines for the clinical use of red cell transfusions. Br J Haematol 93:242–255Google Scholar
- 14.Sehat KR, Evans R, Newman JH (2004) Hidden blood loss following hip and knee arthroplasty: correct management of blood loss should take hidden loss into account. JBJS (Br) 86B:561–565Google Scholar
- 26.Franchini M, Regis D, Gandini G, Corallo F (2016) Preoperative autologous blood donation in primary total knee arthroplasty: the experience of the transfusion centre of Verona. Blood Transfus 4:189–195Google Scholar