PurposeTranexamic acid (TXA) is effective in reducing blood loss in primary total knee replacement. Almost all studies used an intravenous form or a topical form. The aim of this study was to assess the blood sparing efficacy and the safety of oral TXA.Materials and MethodsAll patients with primary total knee replacement performed in our institute from January 2015 to October 2015 were eligible. Oral TXA group was given 1 g oral TXA 2 hours before induction of anesthesia and 6 hours and 12 hours postoperatively. The control group was not given TXA.ResultsThere were 94 cases in the oral TXA group and 95 cases in the control group. There was no difference in the baseline characteristics. The oral TXA group had a significantly lower hemoglobin drop (1.7 g/dL vs. 2.5 g/dL), lower drain output (154 mL vs. 203 mL), lower hidden blood loss (244 mL vs. 423 mL) and lower total blood loss (398 mL vs. 626 mL). There was no difference in transfusion rate (1.1% vs. 3.2%) and thromboembolic complication. There was no infection or mortality in both groups.ConclusionsOral TXA is effective in reducing blood loss in primary total knee replacement. It is a safe alternative to the intravenous or topical form.

Purpose Medial pivot (MP) TKA has been shown to mimic normal knee kinematics with long-term survivorship comparable to most contemporary TKA. However, there are inadequate evidences to suggest its superiority in terms of patient preference and satisfaction. The aim of this study is to compare the MP with posterior-stabilized (PS) TKA in terms of patient preference and satisfaction. Methods 46 patients with staged bilateral TKA were recruited. TKA with MP or PS design was performed at interval of 6-12 months. Patient preference, patient satisfaction score (0-100), Forgotten Joint Score (FJS), range of motion (ROM), Pain Score, Knee Society Score (KSS), Knee Function Score (KFS) and WOMAC Score were compared at up to 12 months. Results The mean age was 70 and 69.6% were female. There was no diference in all preoperative parameters, operative time and length of stay between two knees. No diference was found in in range of motion and all outcome scores at 6 months and 12 months. Satisfaction score was similar for the two designs (82 vs 85, p = n.s.) at 1 year after the second TKA. Proportion of patients with preference on one design over another was not signiicantly diferent (28.9 vs 35.6%, p = n.s.). Conclusions There is no evidence to support the superiority of MP TKA over PS TKA in terms of preference and satisfaction. The choice between MP TKA versus PS TKA maybe more a surgeon's preference than a patient's preference based on current evidence.

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Purpose. To evaluate the incidence and risk factors of periprosthetic joint infection (PJI) in patients undergoing total knee arthroplasty (TKA) in a highvolume hospital. Methods. Records of 1133 primary TKAs were reviewed. Correlation between surgery volume and infection rate was determined. Risk factors for PJI were identified using case-control analysis of variables. TKAs performed between October 2012 and March 2013 without infection were used as controls. Results. Of 1133 TKAs, 8 (0.71%) PJI occurred. The organisms involved were Staphylococcus aureus (n=4), coagulase-negative staphylococci (n=2), Pseudomonas aeruginosa (n=1), and methicillin-resistant S aureus (n=1). In the 6-month period chosen as the control period, one (0.52%) out of 192 TKAs developed PJI. Hospital annual volume did not correlate with infection rate (p=0.766). Significant risk factors included young age, comorbidities such as diabetes,

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