The Effect of Topical Tranexamic Acid versus Injection into the Clamped Drain on Postsurgical Bleeding in Knee Arthroplasty Surgery: A Double-Blind Randomized Clinical Trial Study

Abstract

Background: Knee arthroplasty is one of the most effective treatments in osteoarthritis. However, postsurgical bleeding, followed by blood transfusion, is one of the important complications. This study aimed to compare the effect of topical versus injection of tranexamic acid into the clamped drain on postsurgical bleeding in knee arthroplasty surgery. Methods: In this double-blinded clinical trial study, patients with primary osteoarthritis were randomly divided into three groups to receive placebo injection into the drain clamp, tranexamic acid injection into the drain, and topical tranexamic acid, respectively. Demographic data, as well as hemoglobin level before surgery, and 12 and 48 hours after it were recorded. Data analysis was done using chi-square, ANOVA, and t tests via SPSS software. Findings: 75 patients (67 women and 8 men) with mean age of 63.26 ± 5.15 years were enrolled. Mean hemoglobin level was 13.29 ± 1.23 g/dl before the surgery and did not have any difference between the three groups (P = 0.891). Considering the level of hemoglobin after 48 hours, it decreased significantly more in group of tranexamic acid injection into the clamped drain compared to other groups (P = 0.001). Conclusion: Topical and injection into the clamped drain of tranexamic acid could be effective in reducing the need for blood transfusion and the degree of anemia in patients undergoing knee arthroplasty surgery, but the difference was not significant in this study.

Keywords

• Tranexamic acid
• Arthroplasty
• Knee
• Hemorrhage