Effectiveness of Tranexamic Acid in revision total knee arthroplasty


Published online: Feb 27 2012

Xavier AGUILERA, Sebastià VIDELA, Marta ALMENARA, Jose Antonio FERNANDEZ, Ignasi GICH, Fernando CELAYA

From the Hospital de la Santa Creu i Sant Pau (Universitat Autònoma de Barcelona), Barcelona, Spain

Abstract

The effectiveness of Tranexamic Acid (TXA, antifibrinolytic drug) in reducing allogeneic blood transfusion requirements has not been tested in revision total knee arthroplasty. The aim of this study was to assess the effectiveness of TXA after two intravenous doses of 1 g each. Between April 2006 and February 2010, 68 consecutive patients (19 male, 49 female) of 74 ± 6 [m ±SD] years of age were included and divided into three groups : control (28 patients), in which TXA was not administered but was not contraindicated ; TXA (19 patients) who received TXA, and NO-TXA (21 patients), who were not administered TXA because of a contraindication. The proportions of patients transfused were 54%, 32% and 62% respectively in the control, TXA and NO-TXA group ; the median numbers of RBC units transfused were respectively 2 [range : 1-4], 2 [range : 2-2] and 2.5 [range : 1-5], (p = 0.057). Mean total estimated blood loss was 1693 mL (SD : 689) in the control group, 1196 mL (SD : 665) in the TXA group and 2454 mL (SD : 2166) in the NO-TXA group, (p = 0.015). No adverse events were reported. TXA administration appeared as an effective and safe means of reducing blood transfusion requirements and blood loss in revision total knee arthroplasty.