Topical Tranexamic Acid Reduces Blood Loss and Transfusion Rates in Total Hip and Total Knee Arthroplasty

Abstract

The objective of this study was to determine if tranexamic acid (TXA) applied topically reduced postoperative bleeding and transfusion rates after primary total hip arthroplasty (THA) and primary total knee arthroplasty (TKA). Two hundred and ninety consecutive patients from a single surgeon were enrolled. In TKA, TXA solution was injected into the knee after closure of the arthrotomy. In THA, the joint was bathed in TXA solution at three points during the procedure. In both THA and TKA the TXA solution was at a concentration of 3gm TXA per 100mL saline. The mean blood loss was significantly higher in the non-TXA patients in both TKA and THA groups. Postoperative transfusions decreased dramatically with TXA, dropping from 10% to 0%, and from 15% to 1%, in the TKA and THA groups, respectively. Topical application of TXA significantly reduces postoperative blood loss and transfusion risk in TKA and THA.

Repeated doses of intravenous tranexamic acid are effective and safe at reducing perioperative blood loss in total knee arthroplasty

“…Zohar et al (27) implants (30)(31)(32)(33) and favored based on the concern that systematic administration of IV-TXA might potentially increase the risk of thrombosis (34). In contrast, the TEG data obtained in the current study suggest that IV-TXA did not promote hypercoagulation since the mean CI in the TXA and FS + TXA groups was less than +3 and this CI remained similar to that of the control group during hospitalization.…”

Intra-Articular Administration of Tranexamic Acid in Total Hip Arthroplasty

“…Intra-articular administration of TXA significantly reduces haemoglobin drop and total blood loss during THA, [26][27][28][29] but is less effective in reducing the need for blood transfusion: some studies report a 14% to 20% reduction, [26][27][28] but others report no difference. 29,30 It also reduces the length of hospital stay by 0.6 to 1 day, [26][27][28] with minimal or no increase in infection or venous thromboembolic events.…”

“…29,30 It also reduces the length of hospital stay by 0.6 to 1 day, [26][27][28] with minimal or no increase in infection or venous thromboembolic events. 26,27,29,30 In our study, total blood loss was calculated by the haemoglobin balance method.…”

“…Intraarticular administration of TXA is effective in reducing blood loss during total knee arthroplasty (TKA), [22][23][24][25] but in THA, its effect remains controversial. [26][27][28][29][30] This study evaluated the effectiveness of intra-articular TXA in reducing blood loss and the need for blood transfusion during THA.…”

Total Knee Arthroplasty?; Post Operative Mean Blood Loss With Tranexamic Acid, Is Tranexamic Acid Effective in Reducing Blood Loss. A Randomized Controlled Trial in Tertiary Care Hospital, Pakistan

“…5 Wind TC et all in their study found that there were no transfusions with topical TXA. 6 Sa-ngasoongsong P et all found that the clamping of drain along with tranexamic acid reduce the post-operative blood loss more than 2 the clamping of drain and tranexamic acid alone 7 Soni A et all found that intra-articular tranexamic acid is equally effective as three dose intravenous regimen in reducing blood loss during total knee arthroplasty surgery. 8 Different approaches had been used for the use of tranexamic acid in reducing blood loss but still debates exists.…”