Does Topical Tranexamic Acid Make Bilaterally Total Knee Arthroplasty Safer and Effect Early Functional Outcomes?

Abstract

The aim of this study was to show the effects of intra-articular topical tranexamic acid administration on the postoperative bleeding and early postoperative functional outcomes in the simultaneous bilateral total knee arthroplasty. To determine its effectiveness in reducing the need for blood transfusion, the number of the complications and morbidity rate.
Material and Method. 40 patients who underwent simultaneous bilateral total knee arthroplasty between January 2015 and September 2018 were included in the study. The patients were divided into two groups: patients receiving tranexamic acid (group 1) or patients not receiving (group 2). Tranexamic acid was prepared as 1 g in 100cc sf and administered intra-articular through the hemovac drain following the closure of the surgical wound. Retrospectively, the amount of bleeding from the hemovac drain, blood transfusion needs, postoperative complication rates recorded. Early postoperative functional outcomes including range of motion (ROM) of the knee and the cadence were evaluated.
Results. There was no statistical difference between the two groups in terms of demographics and preoperative hemoglobin, platelet counts. In Group 1, the mean amount of hematoma from the hemovac drain was 592.5 cc on the 1st day; 291.25 cc on 2nd day and total blood loss was 881.25 cc, whereas, in Group 2, it was 1360 on the 1^st day, 412.50 on the 2^nd day and 1770 cc in total, respectively. An average of 1.5 (0-4) units of blood transfusions was performed in Group 1 and 4 (2-5) units in Group 2. There were no differences between two groups in terms of ROM and cadence. Complications such as infection or pulmonary embolism were not defined in the two groups.
Discussion. Intra-articular usage of tranexamic acid makes bilateral simultaneous knee arthroplasty safer reducing bleeding. But It has no impact on early postoperative functional outcomes. It does not increase the risk of complications as well.

Key words:

knee arthroplasty, tranexamic acid, blood loss, functional outcomes

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