The Effect of Tranexamic Acid on Blood Loss and Transfusion Rate in Primary Total Knee Arthroplasty

Abstract Allogeneic blood transfusions remain common in primary total knee arthroplasty. We reviewed our experience with 2269 consecutive primary total knee arthroplasties in 2069 patients over a 3.5 year period. In our cohort, 1838 received no TXA, 330 received TXA via IV infusion, and 130 had TXA...

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Bibliographic Details
Published in:The Journal of arthroplasty 2013-08, Vol.28 (7), p.1080-1083
Main Authors: Wind, Tyler C., MD, Barfield, William R., PhD, Moskal, Joseph T., MD, FACS
Format: Article
Language:English
Subjects:
Administration, Topical
Adult
Aged
Aged, 80 and over
Antifibrinolytic Agents - administration & dosage
Arthroplasty, Replacement, Knee
blood loss
Blood Loss, Surgical - prevention & control
Blood Loss, Surgical - statistics & numerical data
Blood Transfusion - statistics & numerical data
Chi-Square Distribution
Female
Hematocrit
Humans
Infusions, Intravenous
Male
Middle Aged
Orthopedics
total knee arthroplasty
tranexamic acid
Tranexamic Acid - administration & dosage
transfusion rate
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Summary:Abstract Allogeneic blood transfusions remain common in primary total knee arthroplasty. We reviewed our experience with 2269 consecutive primary total knee arthroplasties in 2069 patients over a 3.5 year period. In our cohort, 1838 received no TXA, 330 received TXA via IV infusion, and 130 had TXA applied topically. The need for blood transfusion, as well as hematocrit levels immediately after surgery in the recovery room and the day of discharge were recorded. Tranexamic acid infusion demonstrated a statistically significant decrease in blood transfusion ( P = 0.001), as did topical application of TXA ( P = 0.019). The transfusion rate without TXA was 6.5% (120/1839) but only 0.3% (1/330) with TXA infusion. There were no transfusions (0/130) with topical TXA. Statistical differences were also noted in both immediate post operative and day of discharge hematocrit levels in patients having TXA infusion while those values for patients with TXA irrigation failed to obtain statistical significance. No significant change in the rate of symptomatic deep venous thrombosis or pulmonary embolism was noted.
ISSN:0883-5403
1532-8406
DOI:10.1016/j.arth.2012.11.016