Effect of a single injection of tranexamic acid on blood loss after primary hybrid TKA

Abstract

BackgroundControl of perioperative blood loss is important in total knee arthroplasty (TKA), especially cementless or hybrid TKA. There is increasing interest in the use of tranexamic acid (TXA) for this purpose, however, studies to date have mainly evaluated the effects of various TXA administration regimens on patients who have undergone cemented TKA. We sought to determine (1) whether administration of TXA reduces blood loss after hybrid TKA, and (2) whether an autologous blood reinfusion system is necessary in TKA patients who are treated with TXA. MethodsNinety-five patients (100 knees) who underwent hybrid primary TKA (cemented tibia, uncemented femur) were included in this study. The initial 50 knees were treated without TXA and the following 50 were treated with TXA. Intravenous TXA (1000mg) was administered shortly before deflation of the tourniquet. All continuous variables were expressed as median values. ResultsTotal volumes of blood lost at postoperative 1day were 590mL and 150mL and autotransfusion of collected blood was performed in 88% and 16% of patients in the without and with TXA groups, respectively. A median volume of 400mL of collected blood was returned to the patients in the without TXA group, and 0mL to the patients in the with TXA group. The calculated volumes of blood lost were 761mL and 683mL (p=0.2250), respectively. ConclusionsOne intravenous injection of 1000mg TXA may help to control postoperative blood loss and reduce the need for postoperative autologous blood reinfusion after hybrid TKA. Level of evidenceLevel II.