Intravenous Tranexamic Acid before and after Tourniquet Use Can Reduce Blood Loss and Blood Transfusion after Total Knee Arthroplasty
Surin Numkanisorn MD*, Keerati Chareancholvanich MD**, Chaturong Pornrattanamaneewong MD**
Affiliation : * Department of Orthopaedic Surgery, Taksin Hospital, Bangkok, Thailand ** Department of Orthopaedic Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Tranexamic acid (TXA) is commonly used to reduce blood loss and blood transfusion in total knee arthroplasty
(TKA). However, studies regarding the efficacy of intravenous TXA given during the intra-operative period are limited.
Objective : To study the efficacy of intra-operative TXA regimen on reducing blood loss and blood transfusion in TKA.
Material and Method: In this retrospective comparative study, 60 patients were divided into two groups. Patients in Group
1 were given 10 mg/kg intravenous TXA 10 minutes before inflation of the tourniquet and again immediately after deflation
of the tourniquet. Patients in Group 2 did not receive TXA. Blood loss, blood transfusion, and complications were compared
between the two groups.
Results : Study findings revealed that intra-operative TXA regimen could significantly reduce drained blood (660±117.8 ml
vs. 1,141.7±157.9 ml, p<0.001), decreasing hemoglobin at 12 hours (1.8±0.3 g/dL vs. 2.5±0.5 g/dL, p<0.001) and blood
transfusion (26.7% vs. 80.0%, p<0.001) with no increase in procedure-associated complications.
Conclusion : Intra-operative TXA regimen has the efficacy on reducing blood loss and blood transfusion requirement in
TKA without potential risk of complications.
Keywords : Tranexamic acid, Knee arthroplasty, Blood loss, Transfusion
