Topical usage of Tranexamic Acid: Comparative Analysis in Patients with Bilateral Total Knee Replacement
نویسندگان
چکیده
Aim: Topical Tranexamic acid (TXA) application provides maximum concentration of TXA at the bleeding site and avoids potential systemic effects. A number of blinded randomized control trials (RCT) have been published proving its safety and effectiveness. We hypothesised that in a person undergoing total knee replacement, if TXA was used topically on one side, it would reduce blood loss compared to the other. Methods: A cohort of twenty-eight patients who were part of a larger randomized control trial was identified. Each patient had sequential bilateral TKR; one side received placebo in the form of normal saline, while tranexamic acid had been used on the other side. The primary outcome was blood transfusion rate. Comparing the blood loss separately in two knees of the same patient has the added advantage of reducing any bias that may be present due to inherent physiological differences in individuals. Results: 6 (21.5%) patients needed blood transfusion following TKR on the placebo side while none needed on the side where tranexamic acid was used. Average postoperative hemoglobin and haemotacrit drop was 3.2 and 0.09 respectively on the placebo side. This compared to 1.8 and 0.05 respectively on the test (TXA) side. Average drain output on the placebo side was 468.64 ml compared to 261.6 ml on the test side. Conclusion: In the same patient undergoing TKR on both side, topical application of Tranexamic acid resulted in significant reduction of drain output, Hb drop and blood transfusion rates when compared to the knee where it wasn’t used.
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Which Route of Tranexamic Acid Administration is More Effective to Reduce Blood Loss Following Total Knee Arthroplasty?
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