Intra-articular injection of tranexamic acid reduces not only blood loss but also knee joint swelling after total knee arthroplasty

• Published in: International orthopaedics Vol. 35; no. 11; pp. 1639 - 1645
• Main Authors: Ishida, Kazunari, Tsumura, Nobuhiro, Kitagawa, Atsushi, Hamamura, Sayaka, Fukuda, Koji, Dogaki, Yoshihiro, Kubo, Seiji, Matsumoto, Tomoyuki, Matsushita, Takehiko, Chin, Takaaki, Iguchi, Tetsuhiro, Kurosaka, Masahiro, Kuroda, Ryosuke
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.11.2011
• Subjects: Aged; Antifibrinolytic Agents - therapeutic use; Arthroplasty, Replacement, Knee - adverse effects; Arthroplasty, Replacement, Knee - methods; Blood Loss, Surgical - prevention & control; Edema - prevention & control; Female; Fibrinolysis - drug effects; Humans; Injections, Intra-Articular; Knee Joint - drug effects; Knee Joint - pathology; Knee Joint - surgery; Male; Medicine; Medicine & Public Health; Original Paper; Orthopedics; Osteoarthritis, Knee - surgery; Prospective Studies; Tranexamic Acid - therapeutic use; Treatment Outcome; Total Knee Arthroplasty Patient; Tranexamic Acid; Total Knee Arthroplasty; Allogeneic Blood Transfusion; Venous Thromboembolic Event
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-010-1205-3

Purpose This is a randomised controlled trial to examine whether intra-articular injection of tranexamic acid (TXA) decreases blood loss, as well as reducing leg swelling after total knee arthroplasty (TKA). Methods We performed 100 TKA in osteoarthritis patients. At closure, a total of 2,000 mg/20 ml TXA was injected into the knee joint through a closed suction drain (TXA group). For the control group, the same volume of physiological saline was injected. The pre-operative condition of the patients, post-operative haemoglobin (Hb) levels, discharge volumes from drain, D-dimer and needs for transfusion were compared between these two groups. Furthermore, leg diameters (thigh, suprapatellar portion and calf girth) were measured pre- and post-operatively to investigate whether TXA has an influence on leg swelling after surgery. Results The results revealed that post-operative decrease in Hb level was significantly reduced in the TXA group. Furthermore, knee joint swelling after operation was significantly suppressed in the TXA group compared to the control group. Conclusions The results revealed intra-articular administration of TXA decreased not only blood loss, but also knee joint swelling after TKA.