The Clinical Research of Joint Application of Tranexamic Acid on Postoperative Blood Loss in Total Knee Arthroplasty

Zhao Yujun; Wang Xiaotie

Abstract：Objective To study postoperative blood loss in total knee replacement(TKR)using intra-articular applica-tion of tranexamic acid(IA-TXA)and to evaluate the effectiveness in conventional TKR on blood loss and blood transfusion reduction. Methods Between 2013 and 2015,a randomized controlled study was conducted in 154 patients undergoing con-ventional TKR because of severe osteoarthritis. The patients were allocated into two groups according to intra-articular solution received:study group(TXA 500 mg with 50 mL saline,78 cases)and control group(50 mL saline,76 cases). The solution was injected after wound closure followed by drain clamping for 2 hours. The patients were assessed by maximum blood loss,in-traoperative blood loss,wound drainage,hidden blood loss,decrease of hemoglobin level at 1 d and 3 d after operation,degree of lower limbs swelling,the condition of lower limb function recovery between the two groups. Results The statistical differ-ences were detected between the two groups in terms of total blood loss,wound drainage,hidden blood loss,decrease of hemoglo-bin level at 3 d,the rate of transfusion,the sizes of ecchymosis and the degree of lower limbs swelling(P ﹤ 0. 05). Intraoperatve blood loss was non-significant difference between groups(P ﹥0. 05). Conclusion Topical tranexami acid combined with tempo-rary clamping of drain could reduce postoperative blood loss and transfusion without significant difference in complication.