A prospective randomized placebo-controlled study evaluating the safety and benefits of tranexamic acid injections for primary unilateral total knee replacement.

Abstract

Background: One of the primary issues following total knee arthroplasty (TKA) is blood loss. According to the research, tourniquet time which works by inducing fibrinolysis activity is one of the primary factors contributing to blood loss. This element gives the surgeon the chance to reduce blood loss, which subsequently avoids allogenic blood transfusion and any associated risks. Both oral and intravenous administrations of tranexamic acid (TXA) are acceptable. There is disagreement over the ideal administrative mode. Because TXA is delivered locally, it has a higher chance of being both safe and effective at the target site due to the drug's low systemic absorption.

Materials and methods: We conducted a prospective trial involving 50 unilateral TKA procedures. In 25 TKR following closure, intra-articular TXA was administered, and in 25 TKR, 0.9% normal saline of equivalent volume was provided. Hemoglobin, hematocrit, and the number of patients needing blood transfusions and blood collection in the drain after surgery were used to gauge the effectiveness. Complications were assessed using lower leg Doppler ultrasonography to detect deep vein thrombosis (DVT).

Results: Despite the control group receiving more blood transfusions, we observed a substantial decrease in hemoglobin in the TXA group (P < 0.002) and a significant decrease in drain collection (95% CI: 203.8-406.2, P < 0.001). There were no DVT patients in.

Conclusion: TXA injected intra-articularly appears to be a safe and effective way to lessen post-TKA blood loss and the need for blood transfusions.