Tranexamic acid reduces blood loss in simultaneous bilateral total knee arthroplasty: a randomized control trial

Total knee arthroplasty (TKA) is a common procedure, and bilateral TKA ensures cost efficiency. Bilateral TKA is associated with increased requirement of blood transfusion (BT). BT is associated with hazards, therefore be avoided. Tranexamic acid (TXA) has been suggested to reduce the BT, and the use of TXA in bilateral TKA appears sparse in literature. This study aimed at assessing the effect of TXA in such patients. This prospective randomized controlled trial evaluated the use of TXA in bilateral TKA. Pre- and postoperative hemoglobin (Hb) and packed cell volume (PCV), blood loss and BT, hospital stay, and the cost of TXA compared to blood transfusion were the measured variables. 175 patients (n = 88 TXA, n = 87 CTRL) completed the study. The patients in the control (CTRL) group on an average received 0.3 units and 0.07 in TXA group. The average blood loss in the TXA group was significantly less than the CTRL (P < 0.0001). There was no significant difference in the perioperative complications, hospital stay in the two groups. The use of TXA reduces the postoperative blood loss. The allogenic BT requirement in patients undergoing bilateral TKA is significantly decreased. The routine use of this drug is cost-effective and reduces postoperative blood loss.