Topical Tranexamic Acid Reduces Drainage Blood Loss in Primary Total Knee Arthroplasty: A Retrospective Study

Abstract

Introduction: Total knee arthroplasty (TKA) surgery is associated with significant bleeding and commonly requires allogeneic blood transfusion. Although tranexamic acid (TXA) is reported to reduce post-operative bleeding, concerns on the safety of systemic TXA and of patients with higher risk of deep-vein thrombosis or pulmonary embolism have hindered its wider use. This retrospective study aimed to assess the safety and efficacy of topical TXA in patients undergoing primary TKA. Patients and methods: Between January 2008 and December 2011, a consecutive series of 271 patients who underwent TKAs in hospital single medical center were reviewed. The TXA group received topical tranexamic acid at the end of surgery while the control group did not. Drainage blood loss was measured and the need for blood transfusion was noted. Results: Drainage blood loss was significantly lower in the topical TXA group (304.9 ± 151.2 ml) than in the control group (520.2 ± 251.2 ml) (p ＜ 0.001). Blood transfusion rate was apparently lower in the TXA-treat group (14.3%) when compared to the group without TXA (44.4%) (p=0.013). There was no increase in deep vein thrombosis or wound complication. Conclusions: In this study, topical TXA can effectively reduce blood loss and transfusion rate, and is not associated with any increase in surgical complications.