Comparison of Combined Intraarticular and Intravenous Administration of Tranexamic Acid with Intraarticular and Intravenous Alone in Patients Undergoing Total Knee Arthroplasty without Drainage Catheter: A Clinical Trial Study

Objectives: We aimed to assess the most effective route for Tranexamic acid (TXA) administration among Intraarticular (IA), Intravenous (IV), and combined IA/IV for Total Knee Arthroplasty (TKA) surgeries.Methods: A double-blinded clinical trial was run on ۱۴۷ TKA candidates. Blood loss and hemoglobin (Hb) drop were evaluated using the Gross and Nadler formula in three matched case groups administered TXA during the TKA through IV, IA, or combined IA/IV route. Tourniquet was used on all operations for controlling intraoperative blood loss. No drainage catheter was used for the cases. Results: The combined group showed an average blood loss of ۶۳۰±۲۵۲ ml, which was significantly lower than that in the IV group (۸۷۸±۲۶۸ ml, P<۰.۰۱) and the IA group (۷۷۴±۲۸۸ ml, P=۰.۰۳). Furthermore, the mean Hb and hematocrit drop were significantly lower in the combined group, compared to the other two groups, ۴۸ and ۷۲ h postoperatively (P<۰.۰۵).Conclusion: The combined IA/IV route had a ۲۸% and ۱۹% reduction of blood loss, compared to the IV or IA methods, respectively. Therefore, using TXA via the combined IA/IV route may be more effective for reducing perioperative blood loss following TKA surgery using a tourniquet without drain placement. Level of evidence: I

کلیدواژه ها:

Blood loss ، Surgical ، Total knee arthroplasty ، Tranexamic acid