title: Intra-articular injection of tranexamic acid to reduce blood loss after total knee arthroplasty.
abstract: OBJECTIVE
  To evaluate the effect of intra-articular tranexamic acid (TXA) on blood loss after total knee arthroplasty (TKA).
  
  
  METHODS
  Medical records of 73 men and 93 women (mean age, 68 years) who underwent primary TKA for osteoarthritis and received intra-articular TXA 1500 mg (n=56) or 3000 mg (n=56) or not at all (n=54) were reviewed. Reduction in haemoglobin levels on days 1 and 2 was measured, as were the rates of venous thromboembolism (VTE) and blood transfusion.
  
  
  RESULTS
  Reduction in haemoglobin levels on day 2 was significantly greater in controls (35 ± 11 g/dl) than the 1500 mg TXA group (29 ± 9 g/dl, p=0.005) and the 3000 mg TXA group (23 ± 10 g/dl, p<0.001). The difference between the 2 TXA groups was also significant (p=0.002). There was a dose-dependent effect of TXA on blood loss. The rates of VTE and blood transfusion did not differ significantly between groups.
  
  
  CONCLUSIONS
  Intra-articular administration of TXA is effective in reducing blood loss after TKA, without increasing the risk of VTE.
authors.affiliation: Sydney Knee Specialists, Edgecliff, NSW, Australia.
authors.forename: Bob
authors.initials: B
authors.lastname: Jang
authors.affiliation: Sydney Knee Specialists, Edgecliff, NSW, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Kao
authors.affiliation: Alliance Anaesthetics, St George Private Hospital, Kogarah, NSW, Australia.
authors.forename: Martin T
authors.initials: MT
authors.lastname: Bohm
authors.affiliation: South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, Australia.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Harris
authors.affiliation: Sydney Knee Specialists, Edgecliff, NSW, Australia.
authors.forename: Darren B
authors.initials: DB
authors.lastname: Chen
authors.affiliation: Sydney Knee Specialists, Edgecliff, NSW, Australia.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: MacDessi
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D001803:Blood Transfusion; D004305:Dose-Response Relationship, Drug; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007270:Injections, Intra-Articular; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*; D054556:Venous Thromboembolism / Q000453:epidemiology
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D014148:Tranexamic Acid
keywords: arthroplasty, replacement, knee; hemorrhage; hemostasis; tranexamic acid