Study of the Tranexamic Acid Influence on Blood Loss in Arthroplasty

Within the period 2010-2012, a prospective study has been conducted in order to examine the blood-saving effect of the tranexamic acid (TXA) in total knee (TKA) and hip arthroplasty. There were 100 TKA, 50 total hip replacements. A total of 3.000 mg/30 mL TXA + 60 ml saline solution has been injected intra-articular at closure into the knee joint through a closed suction drain and then the tourniquet was released. In hip joint, the injection was performed at the end of the skin closure. Then the drain was closed for 6 hours and then activated. Total blood loss was calculated from the maximum loss of hemoglobin (Hb). The hemoglobin levels, the volumes from drainage and pre- and post-operatively leg diameters (thigh, suprapatellar portion and calf girth) have been analyzed post-operatively. All patients were followed clinically to detect presence of venous thromboembolism (VTE). The results revealed that post-operative decrease in Hb level was significantly reduced after tranexamic injection (1.7 units), whereas the need for postoperative blood transfusion decreasedby 90%.The mean postoperatively blood loss in drainage was 150m (50- 325mL). Furthermore, knee joint swelling after operation was significantly reduced. There wasn't any systemic reaction or clinical symptoms of deep venous thrombosis (DVT).