Does Tranexamic Acid Reduce Blood Loss in Total Knee Arthroplasty?

Abstract

The purpose of the study by Aguilera et al.1 was to assess the clinical effectiveness of two commonly used intraoperative techniques that are currently utilized in total knee arthroplasty to reduce blood loss. These were the application of fibrin glue and the intravenous administration of tranexamic acid. Prospective randomized clinical trials such as this one are critical for clinicians who currently care for patients who are undergoing total knee arthroplasty because often the literature is unclear as to which techniques are most efficacious. Currently, many approaches are utilized to reduce blood loss and the need for transfusions in total knee arthroplasties. These techniques include various electrocautery devices, pharmacological agents, as well as intravenous agents. It has been well-documented within the orthopaedic literature that excessive blood loss has been associated with increased hospital stays, increased complications, increased costs, and decreased patient satisfaction. In addition, the use of allogeneic blood transfusion is not without risk for hypersensitivity reactions and infection. With increased pressures from Medicaid and Medicare to improve quality while reducing costs, there is an increased emphasis on the importance of blood loss studies, such as this one, which attempts to provide Level-I data to help address this quite challenging problem in total knee arthroplasty and to help clinicians make more informed care decisions. In the current study, 172 patients were …