The Safety and Efficacy of Combined Administration of Tranexamic Acid to Reduce Blood Loss on Total Knee Arthroplasty

Abstract：Objective To explore the perioperative efficiency and safety of combined administration of tranexamic acid (TXA)on total knee arthroplasty(TKA). Methods From February 2014 to November 2014,140 female patients with knee osteoarthritis underwent unilateral TKA were sampled,aging from 55 to 83,and the average age was 70. 32. The course lasted from 3 to 15 years. The patients were randomly divided into experimental group(combined administration)and control group (a single administration),70 cases in each group. Patients of both group received 10 mg/ kg of tranexamic acid 10 min before the tourniquet deflation,experimental group were treated with 0. 5 g tranexamic acid intra-articular injection after intraoperative suture of incision,and patients of control group were treated with equal amount of physiological saline. Both groups were com-bined with drain clamping for 2 hours. The dominant blood loss,the hidden blood loss,the postoperative hemoglobin concentra-tion at different times and the number of patients need blood transfusion were recorded. All patients were observed for detecting deep vein thrombosis(DVT)by the color doppler ultrasonography within 5 days postoperation,and the pulmonary embolism (PE)were observed within 90 days after operation. Results The dominant blood loss was significantly less in the experimen-tal group( 210 . 8 ± 9 4 . 8 )mL compared with the control group( 3 1 6 . 6 ± 9 2 . 3 )mL ,the difference was significant( P ﹤0. 05);the hidden blood loss was significantly less in the experimental group(596. 4 ± 92. 8)mL compared with the control group(746. 6 ± 96. 4)mL,the difference was significant(P ﹤ 0. 05). In both groups the transfusion population and ratio of pa-tients had no different. There was no DVT in both groups within 7 days after operation,and there was no symptomatic DVT and PE in both groups with in 90 days. Conclusion 10 mg/ kg of tranexamic acid 10 min before the tourniquet deflated combined with 0. 5 g tranexamic acid intra-articular injection after intraoperative suture of incision with 2 h drain lamping in TKA is ef-fective and safe.