A Comparison Study between 1 gram and 2 grams of Tranexamic Acid for Reducing Blood Loss and Transfusion Requirements in Total Knee Arthroplasty

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Pramook Vanasbodeekul, MD


Objective: To compare the effectiveness between 1 g and 2 g of tranexamic acid on blood loss and packed red cell transfusion requirements in total knee arthroplasty (TKA) in Thai patients.

Methods: This study evaluates the use of TXA in 50 TKA performed in a single surgeon at Priest Hospital between 2014 and 2020. The initial 25 patients underwent surgery with TXA 1 g (TXA1 group) while the subsequent 25 patients all received 2 g TXA (TXA2 group). Perioperative blood loss, postoperative blood loss, total blood loss, postoperative 24hr Hct, total PRC transfusion, and deep vein thrombosis (DVT) were examined.

Results: Total blood loss and postoperative blood loss were significantly higher in the TXA1 group than the TXA2 group (473.2 cc vs 290.6 cc; p-value < 0.001 and 399.6 cc vs 228.2 cc ; p-value < 0.001 respectively). Postoperative 24hr Hct were lower in the TXA1 group than the TXA2 group significantly (33.6±3.0 vs 37.0±4.4; p-value 0.002). However, the transfusion requirements were the same. None of the patients developed DVT.

Conclusion: TXA 2 g can reduce total blood loss more than TXA 1 g significantly without increasing the risk of postoperative DVT.


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