Evaluation of Tranexamic Acid Application without Closed-Suction Drainage versus with Closed Suction Clamping in Patients Undergoing Knee Arthroplasty: A Retrospective Assessment of Blood Loss and Transfusion

Abstract

Background: The objective of this study was to evaluate the effects of eliminating closed suction drainage (CSD) and utilizing intravenous and intra-articular tranexamic acid on blood loss, blood transfusion, hospital stay, and dressing changes subsequent to total knee arthroplasty (TKA) surgery. Methods: A retrospective analysis was conducted on 195 knees of 166 patients who underwent TKA surgery performed by a single surgeon between 2012 and 2022. Patients were divided into two groups based on their use of CSD. Group A (N: 78; 9 males, 69 females; mean age: 72.24±7.29 years) underwent CSD omission and received intravenous and intra-articular tranexamic acid, while Group B (N: 88; 4 males, 84 females; mean age: 71.3±6.9 years) had CSD clamped for 120 minutes postoperatively. Total blood volume loss, number of blood transfusions, length of hospital stay, and dressing changes were compared between the groups. Results: Total blood volume loss was significantly lower in Group A (1155±88 ml) compared to Group B (716ml±78 ml) (p<0.001). Similarly, the mean number of blood transfusions was significantly lower in Group A (1.02±1.08) compared to Group B (0.04±0.194) (p<0.001). The mean hospital stay was 4.09±1.564 days in Group A and 4.7±1.18 days in Group B (p=0.005). The mean number of dressings was 1.18±0.5 in Group A and 3.07±0.85 in Group B (p<0.0001). Conclusions:Administration of intravenous and intra-articular tranexamic acid without employing CSD substantially reduces total blood loss, blood transfusion requirements, number of dressing changes, and hospital stay following TKA surgery.