Comparison of the effect of intravenous and intra-articular injection of tranexamic acid on blood loss in total knee arthroplasty

Objective: To compare the effect of intravenous and intra-articular injection of tranexamic acid on blood loss in total knee arthroplasty (TKA). Methods: A total of 90 patients treated with total knee arthroplasty in our hospital from August 2015 to August 2016 were selected as the objects and divided into observation group and control group according to different treatment methods with 45 cases in each group. The control group were given intravenous drip of 10 mg/kg tranexamic acid during anesthetic induction with the maximum dose of 1 g while the observation group were treated by intra-articular injection of 1 g tranexamic acid after finishing suture but before loosening tourniquet. After that, the blood loss, blood coagulation and the incidence of deep venous thrombosis were observed in the two groups. Results: In the observation group, the postoperative drainage volume was (252.21 +/- 63.98) mL, the occult blood loss was (603.21+/- 59.96) mL and the total blood loss was (923.12 +/- 286.21) mL, significantly less than those in the control group, they were respectively (545.21 +/- 61.98) mL, (882.21 +/- 113.96) mL and (1223.13 +/- 386.25) mL and the difference in between was of statistical significance (P<0.05); there were no significant differences in blood coagulation (PT, APTT, INR) and the incidence of deep vein thrombosis (DVT) between the two groups of no statistical value (P>0.05). Conclusion: Intraarticular injection of tranexamic acid can effectively control blood loss after TKA treatment and avoid the occurrence of deep vein thrombosis, thus worth popularizing.