Prospective study to compare efficacy of systemic, local and combined administration of tranexamic acid in reducing blood loss in total knee arthroplasty

Abstract

Perioperative blood loss is a major challenge to surgeon in TKA. There are different methods to reduce blood loss in total knee arthroplasty (TKA). The efficacy of both systemic and local tranexamic acid (TXA) administration is demonstrated in the literature. The aim of the present study was to compare the efficacy of systemic, local and combined (systemic + local) administration of TXA in reducing blood loss after TKA. 47 patients undergoing TKA were divided into three groups (IV 18 cases; IA 20 cases, and combined (IV + IA) 9 cases) corresponding to the method of TXA administration. Demographic data, preoperative hemoglobin and platelet levels were collected. The primary outcome was the maximum hemoglobin loss, while the secondary outcomes were the amount of blood in the drain (cc/hour) and the rate of transfusions. Student’s t-test or a χ2 test was used to evaluate between-group differences, using p