The use of intravenous tranexamic acid for reduction of blood loss in total knee and hip arthroplasty.
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Abstract
Objective: To evaluate the effect of intravenous tranexamic acid on blood loss and packed red cell transfusion requirements in total knee arthroplasty (TKA) and total hip arthroplasty (THA) in Thai patients.
Methods: This study evaluates the use of TXA in 40 TKA and 40 THA performed in a single surgeon between 2011 and 2015. The initial 20 patients of both groups (TKA and THA) underwent surgery without TXA (no TXA group) while the subsequent 20 patients all received 1 g TXA (TXA group). Perioperative blood loss, postoperative blood loss, total blood loss, postoperative 24hr Hct, total PRC transfusion, and deep vein thrombosis (DVT) were examined.
Results: In both TKA and THA, total blood loss were significantly higher in the no TXA group (TKA: 520 cc vs 395 cc ; P-value 0.019 and THA: 1,445 cc vs 950 cc ; P-value 0.001). Postoperative 24hr Hct were lower in no TXA group in both TKA and THA, but only significant in TKA (TKA: 29.8 ± 3.1 กับ 33.6 ± 3.7; P-value 0.001 และ THA: 30.9 ± 3.3 กับ 31.3 ± 3.7; P-value 0.283). Total PRC transfusion were higher significantly in the no TXA group (TKA: 16 units vs 2 units ; P-value 0.001 และ THA: 48 units vs 11 units ; P-value 0.005). None of the patients developed DVT.
Conclusion: Intravenous TXA can significantly reduce total blood loss and total PRC transfusion in both TKA and THA without significant increase in postoperative DVT.
Key words: Tranexamic acid, Total Knee Arthroplasty, Total hip Arthroplasty
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References
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