Assessment of the Use of Tranexamic Acid After Total Knee Arthroplasty

Abstract

Objective: To evaluate the profile of blood loss and blood transfusions after the introduction of Tranexamic acid (TXA) in a tertiary university hospital in Brazil. Methods: 173 patients were retrospectively divided into two groups: the ones who received TXA and the control group. Hemoglobin levels (Hb), drain output, transfusion rates, and thromboembolic events were measured. Results: Among the patients included in this study, 82 cases received TXA. Blood transfusion occurred in 3 cases of the TXA group (3.7%), and in 27 control group cases (29.7%; p < 0.001). The average Hb decrease was 2.7 g/dl (± 1.39) and the median drain output was 270 mL in the TXA group. In the control group, the values were 3.41 g/dl (± 1.34; p < 0.001) and 460 mL (p < 0.001), respectively. Thromboembolic events occurred in 2 TXA group cases (2.4%) and in 3 control group cases (3.3%; p > 0.999). Conclusion: TXA was effective in reducing blood transfusion rates, Hb decrease, and drain output on the 1st postoperative day without increasing thromboembolic events. Level of evidence III, Retrospective comparative study.

Tranexamic acid is associated with decreased transfusion, hospital length of stay, and hospital cost in simultaneous bilateral total knee arthroplasty

“…The use of a standardized TXA dosing regimen resulted in a significant reduction in allogeneic and autologous transfusion requirements. Our data are consistent with prior published studies with smaller patient populations [ 13 , 14 , 18 , 24 , 25 ]. Our transfusion rate was greater in both groups compared to the trial by Kim et al, which reported transfusion rates of 20% without TXA compared to 5% with TXA [ 16 ].…”

Impact of tourniquet during total knee arthroplasty when tranexamic acid was used: a meta-analysis of randomized controlled trials

“…As for complications, we observed no significant difference in terms of IMVT, DVT, superficial infection, deep wound infection, delayed wound healing between the two groups. Although TXA use in TKA didn’t increase thromboembolic events [ 50 – 53 ], perhaps one of the more significant clinical concerns regarding tourniquet use plus TXA is its association with thromboembolism. No significant difference was found between groups regarding the rate of intramuscular venous thrombosis and deep venous thrombosis in our study.…”

A artroplastia total de joelhos bilateral simultânea pode ser segura

“…The administration of tranexamic acid in bilateral TKA reportedly results in lower blood transfusion rates with no increase in the risk of thromboembolic events. 21 Chalmers et al 7 demonstrated that using a suction drain in TKA doubles the risk of transfusion and do not recommend it. These measures aim to reduce the need for blood replacement.…”

“…O uso do ácido tranexâmico na ATJ bilateral está associado a menores taxas de transfusão de sangue, sem aumentar o risco de fenômenos tromboembólicos. 21 Chalmers et al 7 demonstraram que o uso de dreno de sucção na ATJ aumenta em duas vezes o risco de transfusão e não recomendam seu uso. Essas medidas visaram diminuir a necessidade de reposição sanguínea, pois a probabilidade de infecção superficial e profunda da ferida em pacientes submetidos à artroplastia total de quadril e joelho é significativamente aumentada naqueles que recebem transfusão de sangue, comparativamente àqueles que não receberam.…”