Effectiveness and Safety of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty

Abstract

The meta-analysis shows that the use of tranexamic acid for patients undergoing total knee arthroplasty is effective and safe for the reduction of blood loss.

Intraarticular Fibrinogen Does Not Reduce Blood Loss in TKA: A Randomized Clinical Trial

“…Efforts have been made to use hemostatic agents such as thrombin-based sealants intraoperatively to minimize blood loss and decrease transfusion rates with little success [8]. Systemic tranexamic acid may be a more effective approach [7] but may also be associated with some risks, although recent systematic reviews have failed to demonstrate any difference in adverse events associated with the use of tranexemic acid [1,19]. Topical application of tranexamic acid has been shown to reduce postoperative blood loss [18].…”

Reply to Letter to the Editor

“…Perhaps just as important as tourniquet use is preoperative patient care with cessation of strong anticoagulants, herbal medications known to affect the clotting cascade, and alcohol use within 1 week of the operation. No matter the choice of tourniquet use, we believe the data are clear that tranexamic acid reduces blood loss [14]. Tourniquet use from incision through cementation is safe and effective if the tourniquet pressure is limited to 225-mm Hg [9].…”

“…Matziolis et al [7] found a comparable drop in hemoglobin between study groups. Yang et al [14] failed to differentiate between tourniquet use and no tourniquet use. In their Abstract and Results sections, Vandenbussche et al [12] did not find significant differences in ''measured blood loss or operating time'', but they did find more calculated blood loss with no tourniquet use.…”

Letter to the Editor

“…In the Introduction, the authors compared randomized controlled trials featuring patients undergoing TKA with or without tourniquet that show no statistical difference in blood loss or less blood loss when no tourniquet is used. The authors provided three additional studies [2,6,13] in their References section. However, none of these three papers have studied blood loss with or without tourniquet in TKA.…”

“…However, none of these three papers have studied blood loss with or without tourniquet in TKA. Yang and colleagues [13] investigated the effectiveness and safety of tranexamic acid in reducing postoperative blood loss in TKA, but not of the tourniquet alone. A study by Vandenbussche and colleagues [12] has been quoted as showing no difference or less blood loss without tourniquet.…”