Is local infiltration of Tranexamic acid efficacious in reducing blood loss after simultaneous bilateral total knee Arthroplasty? A prospective randomized study

Background Total knee arthroplasty (TKA) is one of the most successful and effective surgical strategy to enhance the quality of life in patients with end-stage arthritis of knee. Significant blood loss occurring in TKA due to bone cuts, results in wound haematoma, postoperative pain, seroma formation and arthrofibrosis thus leading to impaired final outcome. TKA performed bilaterally under single anesthesia results in substantial perioperative blood loss. Many strategies, including the use of Platelet rich plasma (PRP) and Tranexamic acid (TXA), have been employed to minimize perioperative blood loss and the resultant demand of allogeneic blood transfusion [1-3]. Some researchers have reported the beneficial effects of TXA in TKA when used in an injectable form [4]. But issue of the safety of intravenous (IV) TXA has been raised by arthroplasty surgeons due to the risk of deep vein thrombosis (DVT) or pulmonary thromboembolism in high-risk patients. Even though few studies have highlighted the efficacy of local Tranexamic Acid [2, 5, 6], it is still not very well accepted route of administration amongst the clinicians. Aim of present study was to compare the efficacy of local infiltration versus intravenous administration of Tranexamic acid in reducing perioperative blood loss.

Author(s): Aditya K Aggarwal

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