Effect of tranexamic acid and total knee arthroplasty on perioperative coagulation indices and blood loss in patients with knee osteoarthritis

Purpose: To study the effect of the combination of tranexamic acid and total knee arthroplasty (TKA) on perioperative coagulation indices and blood loss in patients with knee osteoarthritis (KOA). Methods: A total of 78 KOA patients who received TKA in Second Affiliated Hospital of Qiqihar Medical College from July 2020 to July 2022 were recruited and randomized to study and control groups in a ratio of 1:1 (n = 39). Patients in control group received 0.9 % sodium chloride, while those in study group were treated with 0.9 % sodium chloride plus tranexamic acid after TKA. Parameters evaluated include intraoperative bleeding, drainage volume, occult blood loss, and total blood loss.Results: The two groups of patients had similar intraoperative blood loss (p > 0.05). Tranexamic acid significantly reduced postoperative drainage volume, occult blood loss, and total blood loss in TKA patients (p < 0.05). Before and after treatment, no intergroup differences were seen in prothrombin time, activated partial thromboplastin time, fibrinogen, and D-dimer (D-D) levels (p > 0.05). The D-D levels of all patients showed a significant increase after TKA (p < 0.05). Patients with tranexamic acid exhibited significantly higher serum hemoglobin (Hb) concentrations and lower serum white blood cell count (WBC) than those without tranexamic acid during TKA (p < 0.05).Conclusion: Tranexamic acid plus TKA effectively reduces the intraoperative blood loss of KOA patients, restores knee function, improves serological condition, and lowers the incidence of postoperative complications and transfusion risk. Multicenter large-scale trials are, however, required prior to application in clinical practice.