title: A prospective double-blind placebo controlled trial of topical tranexamic acid in total knee arthroplasty.
abstract: Tranexamic acid (TNA) reduces postoperative blood loss in general and obstetrical surgery but there is limited orthopaedic literature regarding its use in the topical setting. To study the effect of topical TNA after primary total knee arthroplasty (TKA), 101 patients were randomized to topical administration of 2.0g TNA in 75mL of normal saline (50 patients) or placebo (51 patients). Operative technique, drug administration, and venous thromboembolism prophylaxis were standardized. All patients underwent screening ultrasound of the operative extremity. Total blood loss was lower in the TNA group (940.2±327.1mL) than the placebo group (1293.1±532.7mL)(P<0.001), and four patients in the placebo group and none in the TNA group received postoperative transfusion (P=0.118). We recommend administration of topical TNA in primary TKA in healthy patients to decrease perioperative blood loss.
authors.affiliation: Division of Adult Reconstruction, Department of Orthopaedic Surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Georgiadis
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Muh
authors.forename: Craig D
authors.initials: CD
authors.lastname: Silverton
authors.forename: Robb M
authors.initials: RM
authors.lastname: Weir
authors.forename: Michael W
authors.initials: MW
authors.lastname: Laker
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000627:therapeutic use*; D020246:Venous Thrombosis / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: blood loss; total knee arthroplasty; tranexamic acid