The effect of local and systemic application of tranexamic acid on the amount of blood loss and allogeneic blood transfusion after total knee replacement

摘要

The effect of local and systemic Tranexamic Acid on blood loss and need for transfusion after total knee replacement was compared prospectively. Between 2012-2013, 90 patients with unilateral TKR were included. They were randomly divided into 3 and 15 mg/kg TXA was infused before and 10 mg/kg 1 hour after surgery in Group 1, 2 gr TXA was used topically in 2 and no TXA was applied in 3. Total blood loss and transfusion rate were used as outcome. Mean amounts of blood loss were 898.03 +/- 298.21, 823.64 +/- 224.33 and 1263.77 +/- 298.79 nil in Groups 1, 2 and 3 respectively. There was a decrease in blood loss in TXA groups (p < 0.001). No difference was found between local and systemic groups (p = 0385). Transfusion wasnot required in TXA groups but it was 8 in control group. No thromboembolic problem was seen in any patient. Since TXA decreased blood loss and lessen the need for transfusion significantly without increasing thromboembolic events in TKR, we suggest its usage in TKR either systemically or topically whenever possible.