Vol. 5, Issue 1, Part A (2021)

Background and Objective: Blood transfusions, which are related with total knee arthroplasty (TKA) and can be risky and expensive, are common because of the high volume of blood lost during the operation. The antifibrinolytic drug tranexamic acid (TXA) has demonstrated anti-bleeding properties in a number of surgical procedures. The purpose of this research was to determine whether transfusion-based tranexamic acid helped patients having total knee arthroplasty (TKA) experience less blood loss during and after the procedure.

Material and Methods: A prospective, randomized controlled experiment was performed with 60 patients slated for primary unilateral total knee arthroplasty. This study was undertaken by the Department of Orthopedics at Fathima Institute of Medical Sciences in Kadapa, Andhra Pradesh, India, from September 2019 to October 2020. Patients were randomly allocated into two groups: Group A (TXA group, n = 30) got 15 mg/kg of intravenous tranexamic acid 15 minutes before to tourniquet release, while Group B (control group, n = 30) received normal saline. Intraoperative blood loss, postoperative drain output, hemoglobin (Hb) levels on postoperative days 1 and 3, and transfusion requirements were documented and analyzed between the groups.

Results: Group A (TXA) had a considerably lower average total blood loss (780±150 mL) than Group B (control) (1220±190 mL) (p<0.001). The TXA group also had a considerably lower postoperative drain output (p<0.01). On both days 1 and 3 after surgery, Group A had a less noticeable decrease in hemoglobin levels (p<0.05). Compared to the control group, which had 10 patients who needed blood transfusions, the TXA group only had 2 (p = 0.01). Both groups did not have any thromboembolic consequences.

Conclusion: Without raising the risk of thromboembolic events, intravenous tranexamic acid effectively decreases perioperative blood loss and transfusion requirements in patients having total knee arthroplasty. As a safe and cost-effective technique, TXA can be suggested for routine use in TKA.