Yoshinori Ishii, Hideo Noguchi, Junko Sato, Chiduru Tsuchiya, Shin-ichi Toyabe
The Knee
Available online 17 January 2015
Available online 17 January 2015
Background
Control of perioperative blood loss is important in total knee arthroplasty (TKA), especially cementless or hybrid TKA. There is increasing interest in the use of tranexamic acid (TXA) for this purpose; however, studies to date have mainly evaluated the effects of various TXA administration regimens on patients who underwent cemented TKA. We sought to determine (1) whether administration of TXA reduces blood loss after hybrid TKA, and (2) whether an autologous blood reinfusion system is necessary in TKA patients who are treated with TXA.
Methods
Ninety-five patients (100 knees) who underwent hybrid primary TKA (cemented tibia, uncemented femur) were included in this study. The initial 50 knees were treated without TXA and the following 50 were treated with TXA. Intravenous TXA (1000mg) was administered shortly before deflation of the tourniquet. All continuous variables are expressed as median values.
Results
Total volumes of blood lost at postoperative 1day were 590ml and 150ml and autotransfusion of collected blood was performed in 88 % and 16% of patients in the without and with TXA groups, respectively. A median volume of 400ml of collected blood was returned to the patients in the without TXA group, and 0ml to the patients in the with TXA group. The calculated volumes of blood lost were 761ml and 683ml (p=0.2250), respectively.
Conclusions
One intravenous injection of 1000mg TXA may help to control postoperative blood loss and reduce the need for postoperative autologous blood reinfusion after hybrid TKA.
Levels of evidence: Level II.
Control of perioperative blood loss is important in total knee arthroplasty (TKA), especially cementless or hybrid TKA. There is increasing interest in the use of tranexamic acid (TXA) for this purpose; however, studies to date have mainly evaluated the effects of various TXA administration regimens on patients who underwent cemented TKA. We sought to determine (1) whether administration of TXA reduces blood loss after hybrid TKA, and (2) whether an autologous blood reinfusion system is necessary in TKA patients who are treated with TXA.
Methods
Ninety-five patients (100 knees) who underwent hybrid primary TKA (cemented tibia, uncemented femur) were included in this study. The initial 50 knees were treated without TXA and the following 50 were treated with TXA. Intravenous TXA (1000mg) was administered shortly before deflation of the tourniquet. All continuous variables are expressed as median values.
Results
Total volumes of blood lost at postoperative 1day were 590ml and 150ml and autotransfusion of collected blood was performed in 88 % and 16% of patients in the without and with TXA groups, respectively. A median volume of 400ml of collected blood was returned to the patients in the without TXA group, and 0ml to the patients in the with TXA group. The calculated volumes of blood lost were 761ml and 683ml (p=0.2250), respectively.
Conclusions
One intravenous injection of 1000mg TXA may help to control postoperative blood loss and reduce the need for postoperative autologous blood reinfusion after hybrid TKA.
Levels of evidence: Level II.
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