The Role of Tranexamic Acid in Reducing Postoperative Hemorrhage Following Bilateral Total Knee Arthroplasty: Our Experience from Developing World

Abstract

OBJECTIVE: To see how effective a dual intravenous (IV) dose of TXA is at reducing postoperative blood loss following primary simultaneous bilateral TKA. METHODOLOGY: A prospective study performed at the Institute of Orthopedics and Surgery in Karachi, Pakistan. Patients included in the study operated on for simultaneous primary bilateral TKA from November 2021 to October 2022. Factors examined between two groups were age, gender, body mass index (BMI), Kellgren Lawrence (KL) classification, comorbid, ASA score, pre-operative and postoperative complete blood count, tourniquet time, number of blood transfusions, Length of hospitalization, and adverse events in first three months. All patients (cases) received a 1gm IV dose of TXA 10 minutes before the tourniquet and surgical incision inflation. Another dose was given after deflation but before the closure of the contralateral surgical wound. The primary endpoint was to determine the number of blood transfusions required, whereas secondary endpoints were the Length of hospitalization and complication rate among both groups. Data was analyzed using IBM SPSS version 20.0. RESULTS: A total of 44 patients were enrolled in the study. The mean age of patients was 66.4±4.3 years. 10(45.4%) patients were male, whereas 12(54.5%) were female. 10(45.4%) patients had type 3, whereas 12(54.5%) had type 4 knee OA. There was a significant reduction in blood transfusion requirement and Length of hospitalization in patients who received a dual 1gm IV dose of TXA during simultaneous bilateral TKA. CONCLUSION: TXA is a safe and effective treatment for reducing postoperative blood loss following simultaneous primary bilateral TKA.

Keywords

• bilateral tka
• estimated blood loss
• tranexamic acid
• blood transfusion