Influence of Limited Tourniquet Use Combined with Intravenous Tranexamic acid on Blood Loss in Total Knee Arthroplasty

Abstract：Objective To investigate influence of limited tourniquet use combined with intravenous tranexamic acid on blood loss perioperative total knee arthroplasty (TKA).Methods The clinical data of 122 patients with knee osteoarthritis undergoing total knee arthroplasty were analyzed retrospectively from March 2013 to August 2016 in our department.The 43 cases were treated with tourniquet without using tranexamic acid (Group A),41 patients were treated with tourniquet and intravenous infusion of tranexamic acid (group B),38 cases were treated with limited tourniquet use and intravenous infusion of tranexamic acid (group C).The sex,age,body mass index (BMI),hemoglobin (Hb) and hematocrit (Hct) of the patient were collected and compared between the three groups.The length of operation,intraoperative blood loss,postoperative drainage,the number of blood transfusion and HSS score were recorded.The Gross formula was used to calculate the total blood loss and the hidden blood loss perioperative total knee arthroplasty.Results The total blood loss in group A and group B and group C was significantly different (P＜0.001).There was no significant difference in total blood loss between group B and group C (P =0.731).The hidden blood loss in group A and group B and group C was significantly different (P＜0.001).The hidden blood loss in group B and group C,the difference was statistically significant (P=0.001).There were 13 cases (30.23％) in group A,3 cases (7.31％) in group B,2 cases (5.12 ％) in group C transfusing,and the rate of transfusion in group A,group B and group C were statistically significant (P＜0.05).There was no significant difference in HSS score between the three groups (F-0.384,P =0.681).Conclusion The use of tranexamic acid in TKA can significantly reduce the total blood loss during the operation and reduce the transfusion rate.Limited tourniquet use in total knee arthroplasty can shorten the time of tourniquet,but it will not increase the operation time and perioperative blood loss.It is recommended for patients with high risk of thromboembolism to reduce the use of tourniquets.