Which Hemostatic Agent Works Best in Reducing Blood Loss in Total Knee Arthroplasty? - A Retrospective Study in University Clinical Hospital Mostar

Abstract

Context: Total knee arthroplasty (TKA) is one of the most performed orthopedic surgeries worldwide. It is accompanied by high blood loss during and after the surgery. Aims: The study aims to determine if hydrogen peroxide (H2O2) is superior to tranexamic acid (TXA) in reducing blood loss during TKA. Subjects and Methods: This research’s total number of participants was 101. Participants were divided into three groups based on the hemostatic agent they received: TXA, H2O2, and control. Postoperative blood loss was measured by taking a blood sample on the operation day, the 1st day, 7th day postoperatively, and on discharge from the hospital. The participants were compared according to blood loss during the timeline, amount of blood transfusions, loss in drains, and patella resurfacing. Statistical Analysis Used: Frequencies of nominal variables were analyzed using the Chi-square test. All continuous data were expressed as mean ± standard deviation. Distribution was normal so the significance of continuous variables was analyzed using one-way analysis of variance test. Results: Patients’ general characteristics, hospital stay, and preoperative hemoglobin (Hb) were similar among the groups. The TXA group had significantly lower Hb loss on the 1st (P = 0.019) and 7th (P = 0.035) postoperative day. The TXA group had the lower number of indicated transfusions (P = 0.001). Drainage blood loss was lowest in the TXA group (P < 0.014). Differences in the volume of lost blood, resurfaced patella, and blood group among the groups were not statistically significant. Conclusions: TXA proved to be more efficient than H2O2 in reducing blood loss, the need for transfusions, and drain blood loss in TKA.