A prospective study on role of tranexamic acid in reducing postoperative blood loss in total knee arthroplasty and its effect on coagulation profile

J Arthroplasty. 2014 Apr;29(4):733-5. doi: 10.1016/j.arth.2013.09.002. Epub 2013 Oct 31.

Abstract

Total knee arthroplasty(TKA) is associated with extensive postoperative blood loss. Despite various studies proving the efficacy of Tranexamic Acid (TEA) with single or multiple boluses of different sizes with or without subsequent infusions, no consensus has been reached on the dose of tranexamic acid to be administered or the duration of treatment. In this study, we have investigated in a homogenous healthy population undergoing total knee arthroplasty, if administration of a high dose of tranexamic acid has a blood sparing effect. They were found to be significant with high power concluding a decrease in total blood loss in patients who were administered Tranexamic Acid (TEA) during Total Knee Arthroplasty (TKA). A dose regimen of 15 mg/kg every 8 h for 24 h would seem appropriate as longer administration of TEA was not accompanied by further reduction in blood loss.

Keywords: total knee arthroplasty; tranexamic acid.

MeSH terms

  • Antifibrinolytic Agents / administration & dosage*
  • Arthroplasty, Replacement, Knee* / adverse effects
  • Blood Coagulation / drug effects*
  • Case-Control Studies
  • Dose-Response Relationship, Drug
  • Female
  • Fibrinolysis / drug effects
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / surgery*
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / prevention & control*
  • Prospective Studies
  • Tranexamic Acid / administration & dosage*

Substances

  • Antifibrinolytic Agents
  • Tranexamic Acid