Abstract
BackgroundThe administration of an intra-articular injection (IAI) of tranexamic acid (TXA) has been demonstrated to be effective in reducing both blood loss and transfusion rate during total knee arthroplasty (TKA); however, few studies have reported the efficiency of a peri-articular injection (PAI) of TXA. We studied the efficiency of a PAI of TXA in reducing blood loss during TKA.MethodsFifty patients undergoing primary simultaneous bilateral TKA were enrolled in this retrospective study. The right knee received a PAI of 1 g of TXA (Group I), and the left knee received an IAI of 1 g of TXA (Group II). The clinical outcome measures were a change in blood loss from Hemovac drains and surgical time.ResultsThe decrease in blood loss from the Hemovac was significantly lower in Group I (460.1 ± 36.79 vs. 576.0 ± 34.01, P < 0.001) than in Group II, and no significant difference in surgical times was observed. The blood transfusion rate in the present study was 16 %.ConclusionsA PAI of TXA may reduce blood loss more efficiently than an IAI of TXA during TKA without increased complications such as surgical site infection, poor wound healing, skin necrosis, pulmonary embolism, and deep vein thrombosis.
Highlights
The administration of an intra-articular injection (IAI) of tranexamic acid (TXA) has been demonstrated to be effective in reducing both blood loss and transfusion rate during total knee arthroplasty (TKA); few studies have reported the efficiency of a peri-articular injection (PAI) of TXA
Aguilera et al [9] reported that the topical administration of 1 g of TXA reduced blood loss in TKA, and Yozawa et al [10] reported that a peri-articular injection of 1 g TXA effectively reduced blood loss compared with placebo treatment in TKA
A total of 50 patients who underwent simultaneous bilateral TKA for advanced knee osteoarthritis between January and August 2017 were included in this retrospective study, which was approved by the Institutional Review Board of our hospital, Taipei Veterans General Hospital (IRB number: 2018-09-004CC)
Summary
The administration of an intra-articular injection (IAI) of tranexamic acid (TXA) has been demonstrated to be effective in reducing both blood loss and transfusion rate during total knee arthroplasty (TKA); few studies have reported the efficiency of a peri-articular injection (PAI) of TXA. Aguilera et al [9] reported that the topical administration of 1 g of TXA reduced blood loss in TKA, and Yozawa et al [10] reported that a peri-articular injection of 1 g TXA effectively reduced blood loss compared with placebo treatment in TKA Aside from these two reports, there are few studies on the efficacy of a periarticular injection (PAI) of a local pain control cocktail combined with TXA in TKA [10,11,12].
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