Efficacy of tranexemic acid in controlling perioperative blood loss in TKR patients using intravenous V/s intraarticular route

Abstract

Preoperative blood loss is common in total knee replacement. Tranexamic acid can reduce active bleeding. It is the most effective antifibrinolytic agent available. Our objective was to compare the efficacy of tranexamic acid in controlling perioperative blood loss in adult patients undergoing total knee replacement using intravenous versus intraarticular route. An analytical cross-sectional study was conducted on 95 patients who underwent total knee replacement surgery in our institution. Patients were selected for intravenous (group A) and intra articular (group B) by simple randomization. During the postoperative period, the amount of blood in the drain and post-operative hemoglobin at 48 hours were collected and total blood loss was calculated. Mean pre-operative hemoglobin in group A was 11.73 and in group, B was 11.86. Average blood loss in the drain was 305 ml and 293 ml in group A and group B respectively. Average total blood loss was 464ml and 438 ml in group A and B respectively. Average fall in Hb was 0.69 and 0.80 in group A and group B respectively at 48hours. One patient in each group was transfused with allogeneic blood. There were no clinically evident DVT cases in either group. In conclusion, both intraarticular and intravenous tranexamic acid were found to be equally effective in controlling perioperative blood loss in total knee arthroplasty patients with no significant increase in thromboembolic complications.