Comparison of intra-articular and intravenous administration of tranexamic acid in patients candidate for total joint replacement surgery

Abstract

Nowadays, Total knee Arthroplasty is used to treat sever osteoarthritis. This surgery is associated with complications such as bleeding during and after surgery, which can lead to increased morbidity and mortality of patients. The use of tranexamic acid to reduce bleeding has become common in recent years, but the occurrence of thromboembolic events has raised concerns. The aim of this study was to evaluate the efficacy, safety and side effects of tranexamic acid in total knee arthroplasty. Materials & Methods: 128 patients participating in the study were randomly divided into 3 groups: intravenous and intra-articular TXA (injection)and control group. Levels of hemoglobin before and after of surgery, volume of intraoperative and postoperative bleeding, duration of hospitalization, infection as well as DVT symptoms in both groups were recorded and analyzed by Spss software. Results: Bleeding during surgery was significantly lower in the intravenous injection group(P<0.001). Bleeding after surgery was less in the local injection group(P=0.013). Patients who received TXA did not need a blood transfusion(P<0.001). DVT was not reported in any of the patients studied.