Abstract
Context: Intravenous (IV) tranexamic acid (TXA) is a goodpotent agent in controlling postoperative blood loss following total knee arthroplasty (TKA). Recently, intraarticular usage of this agent has also shown good results.
Aims: Comparison of postoperative blood loss between IV(intravenous) and topical administration of TXA tranexamic acid in TKAs(total knee arthroplasty)
Materials and Design: Eighty-six TKAs on knees were included in ourstudy. Randomization was done, so that in our study 40 TKA received 1 g of IV TXA, while 46 had underwent intraarticular administration of 1 gm of TXA.
Subjects and Methods: We have compared the postoperative blood loss by calculating the difference in pre- and postop hemoglobin and the need for blood transfusion for patients .The functional assessment was done on basis of Western Ontario McMaster Osteo-Arthritis Index (WOMAC) scores and complications like postoperative infection, oozing from wound site and thromboembolic manifestations.
Results: The blood loss was significantly less in the intraarticular administration group as compared to the IV injection group. The total blood loss, blood transfusion, and drain output was also less but the difference was not significant. The functional assessment (WOMAC) scores were equivocal and so were the complications including thromboembolic manifestations (two cases each of deep vein thrombosis (DVT) .There was no cases of pulmonary embolism (PE)).
Conclusion: The intraarticular administration of TXA to prevent postoperative bleeding or blood loss in TKA is a safe and effective alternative to its intravenous usage.
Keywords: Intraarticular administration, tranexamic acid, total knee arthroplasty.
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Corresponding Author
Dr Noorul Ameen
Junior Resident,
Sree Balaji Medical College and Hospital Chrompet, Chennai
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.38
