ArticleJournal of orthopaedic surgery and research2025
Peri-articular injection of high-dose tranexamic acid after total knee arthroplasty reduces blood loss and transfusion rate.
Article in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
backgroundPerioperative blood loss and the need for transfusion are significant concerns in total knee arthroplasty (TKA). Topical tranexamic acid (TXA) is commonly used to reduce bleeding and is administered either via intra-articular (IAI) or peri-articular injection (PAI). This study aimed to compare the efficacy of PAI and IAI of TXA in reducing the postoperative drainage volume and blood transfusion rates in patients undergoing TKA.
methodsOne hundred patients who underwent simultaneous bilateral TKA were included in this retrospective cohort study. The patients were divided into two groups: Group A received 1 g TXA via PAI and 1 g TXA via IAI in one knee, with 2 g TXA via IAI in the other knee; and Group B received 2 g TXA via PAI in one knee and 2 g TXA via IAI in the other knee. Postoperative outcomes, including blood loss, hemoglobin (Hb) levels, transfusion rates, and surgical duration, were collected and analyzed.
resultsGroup A demonstrated a significantly greater decrease in postoperative Hb levels (-2.03 ± 0.15 mg/dL) than Group B (-1.29 ± 0.11 mg/dL). Knees treated with PAI (391.10 ± 25.45 mL) or PAI + IAI (412.80 ± 26.76 mL) had significantly lower drainage volumes than those treated with IAI alone (523.50 ± 17.47 mL, p < 0.001). No significant differences were observed between the PAI and PAI + IAI subgroups. No major complications such as deep vein thrombosis or wound infections were noted.
conclusionsPAI of TXA, either alone or in combination with IAI, is more effective in reducing postoperative blood loss in TKA procedures than IAI alone. These findings support the use of PAI, particularly with a higher dose of 2 g TXA, as a safe and effective method for minimizing drainage output in patients undergoing TKA.
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