Use of Tranexamic Acid in Reducing Blood Loss after Minimally Invasive Total Knee Replacement

Purpose: The purpose of this study was to investigate the effect of tranexamic acid, a fibrinolytic inhibitor, on blood loss and transfusion after minimally invasive total knee replacement (MIS-TKR). Methods: The prospective comparative patient-blind study enrolled 99 patients who underwent MIS-TKR between July 1 and November 31, 2008. Fifty-two patients received tranexamic acid intravenously (10 mg/kg), and 47 patients received normal saline 10 minutes before deflation of the tourniquet. All patients had chemoprophylaxis for venothromboembolic disease with enoxiparin postoperatively. The incidence of blood transfusion, total blood loss, and amount of drained blood were analyzed over time. Results: The mean total blood loss was 1093 mL in the tranexamic acid group vs 1312 mL in the normal saline group (P=0.003). Postoperative blood drainage in the first six hours was significantly less in the tranexamic group than in the normal saline group. The incidence of allogenic blood transfusion was 15.3% in the tranexamic group and 36.1% in the normal saline group (P=0.03). The mean volume of allogenic blood transfused was 0.3 units per patient in the tranexamic acid group and 0.8 in the normal saline group (P=0.02). The hemoglobin level was significantly higher in the tranexamic acid group than in the normal saline group on the first and second postoperative days. Conclusions: Tranexamic acid seems to be effective in reducing early postoperative and total blood loss and the need for allogenic blood transfusion after MIS-TKR in patients without previous history of thromboembolic disease.

並列關鍵字

tranexamic acid ； minimally invasive total knee replacement ； postoperative blood loss ； allogenic blood transfusion

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