Evaluation of the efficacy of intra-articular tranexamic acid in patients with hypertension undergoing simultaneous bilateral total knee arthroplasty

Abstract

Background: The relationship between hypertension (HT) and increased perioperative transfusion rate in patients who underwent total knee arthroplasty (TKA) was previously investigated in the literature. This phenomenon may also increase the need for blood transfusion in patients who underwent bilateral simultaneous TKA despite using tranexamic acid (TXA). The main purpose of this study was to evaluate the decrease in hemoglobin levels and need for blood transfusion in patients with the diagnosis of HT who underwent bilateral simultaneous TKA after intra-articular (IA) administration of TXA in comparison to those who did not receive TXA. Methods: One hundred and ninety-one patients with the diagnosis of HT who underwent bilateral simultaneous TKA and fulfilled the criteria, were evaluated in this retrospective study. Patients were grouped as TXA group (individuals who received IA TXA) and control group (did not receive TXA). Primary outcome measures were decrease in hemoglobin levels and number of blood units transfused. Results: Both groups were similar in age, gender, body mass index and American Society of Anesthesiologist (ASA) score and no statistically significant differences were observed. There was also no statistically significant difference between groups in terms of decrease in hemoglobin levels ( P =0.844) and number of blood units transfused ( P =0.095). Conclusion: According to our results, in patients with the diagnosis of HT undergoing simultaneous bilateral TKA procedure, no significant difference was observed in the decrease of hemoglobin level and number of blood units transfused between patients who received IA TXA in comparison to those who did not receive TXA. Keywords: tranexamic acid; hypertension; total knee arthroplasty; blood loss; blood transfusion; hemoglobin level