The Effect of Tranexamic Acid on Blood Loss and Transfusion Rate in Primary Total Knee Arthroplasty
Section snippets
Materials and Methods
After IRB approval, 2269 consecutive primary knee arthroplasties in 2069 patients performed by four fellowship trained orthopaedic surgeons between January 2009 and May 2012 were retrospectively reviewed. It was determined whether TXA was utilized and if so, was it given as an intravenous infusion or topically. The patients who did not receive TXA via either route served as the control group. Each patient's chart was reviewed to determine if a blood transfusion was necessary. The immediate
Results
Average patient age in our study was 65.84 ± 10.55 years. There were no significant age differences (P = 0.65) between the genders. The male average age was 65.97 ± 10.61 years while the female average age was 65.76 ± 10.46 years. There were no significant differences in preoperative hematocrit between the groups and the demographics of all groups were similar.
Among 2269 primary TKAs in 2069 patients who underwent total knee arthroplasty at our institution over 3.5 years (January 2009–May 2012), chi square
Discussion
There is a growing body of evidence that TXA, when used either as infusion or topically, has a substantial impact on blood loss and the decreasing need for post-operative transfusion following primary total knee arthroplasty. To our knowledge, this report is the largest series from a single institution.
Since the introduction of TXA at our institution into primary total knee protocol, the transfusion rate has dropped substantially. Looking at the data presented in this study, we feel the drop in
References (25)
- et al.
Risks associated with blood transfusion after total knee arthroplasty
J Arthroplasty
(2004) - et al.
A provincial program of blood conservation: The Ontario Transfusion Coordinators (ONTraC)
Transfus Apher Sci
(2005) - et al.
An analysis of blood management in patients having a total hip or knee arthroplasty
J Bone Joint Surg Am
(1999) - et al.
The relationship between hematocrit, blood lost, and blood transfused in total knee replacement. Implications for post-operative blood salvage and reinfusion
Am J Knee Surg
(1995) - et al.
Activity-based Costs of Blood Transfusions in Surgical Patients at Four Hospitals
Transfusion
(2010) - et al.
Use of intravenous tranexamic acid to reduce allogeneic blood transfusion in total hip and knee arthroplasty: a meta-analysis
Anaesth Intensive Care
(2003) - et al.
Tranexamic acid: a review of its use in surgery and other indications
Drugs
(1999) - et al.
Regional hemostatic status and blood requirements after total knee arthroplasty with and without tranexamic acid or aprotinin
Anesth Analg
(2001) Antifibrinolytics in major orthopaedic surgery
J Am Acad Orthop Surg
(2010)- et al.
Experimental and clinical studies on AMCA, the antifibrinolytically active isomer of p-aminomethyl cyclohexane carboxylic acid
Scand J Haematol
(1965)
Amino methyl cyclohexane carboxylic acid (AMCHA): a new synthetic fibrinolytic inhibitor
Br J Haematol
Tranexamic acid reduces blood loss, transfusion requirements, and coagulation factor use in primary orthotopic liver transplantation
Anesthesiology
Cited by (75)
Updated Clinical Review: Perioperative Use of Tranexamic Acid in Orthopedics and Other Surgeries
2023, Advances in AnesthesiaEfficacy of preoperative autologous blood storage in one-stage bilateral total knee arthroplasty
2022, Journal of Orthopaedic Science
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2012.11.016.