The Effect of Intravenous Tranexamic Acid on Perioperative Blood Loss, Transfusion Requirements, Verticalization, and Ambulation in Total Knee Arthroplasty: A Randomized Double-Blind Study

Abstract

Background and Objectives: Total knee arthroplasty (TKA) is sometimes associated with significant perioperative bleeding. The aim of this study was to determine the efficacy of tranexamic acid (TXA) in reducing perioperative blood loss in patients undergoing primary TKA. The secondary objectives were to assess the efficacy of TXA in reducing the need for blood transfusion in these patients and to determine its effect on verticalization and ambulation after TKA. Materials and Methods: This study included 96 patients who were randomly assigned to two groups, each containing 48 patients. The study group received intravenous TXA at two time points: immediately after the induction with doses of 15 mg/kg and 10 mg/kg 15 min before the release of the pneumatic tourniquet. The control group received an equivalent volume of 0.9% saline solution via the same route. Results: TXA markedly reduced (Z = −6.512, p p = 0.001). Patients in the study group stood (χ2 = 21.162, p p Conclusions: TXA is an effective drug for reducing the incidence of perioperative bleeding, decreasing transfusion rates, and indirectly improving postoperative functional recovery in patients undergoing primary TKA.

Keywords

• tranexamic acid
• total knee arthroplasty
• perioperative bleeding
• transfusion
• verticalization
• ambulation