title: Intravenous use of tranexamic acid reduces postoperative blood loss in total knee arthroplasty.
abstract: BACKGROUND
  Blood transfusion is often required in total knee replacement (TKR); several methods of blood preservation are commonly used but the ideal solution is to reduce the blood loss during and after surgery. Aim of the study was to evaluate the hemostatic efficacy and safety of intravenous use of tranexamic acid in patients receiving TKR (cemented).
  
  
  METHODS
  Forty-five patients after TKR receive treatment with tranexamic acid (TXA, treatment group), and 45 were managed with fibrin tissue adhesive (control group). Hemoglobin values decrease and transfusions in both groups were recorded. Statistical analysis was performed with Student t test and χ (2) test. A statistical model was elaborated to evaluate together all variables and to underline what data can increase transfusions need.
  
  
  RESULTS
  A significant reduction was detected in hemoglobin values in the first 3 days after surgery in the treatment group. The difference in all cases was significant. When tranexamic acid was administered, the need for transfusions was lower (difference statistically significant). No major adverse events were recorded in our series. The use of autologous blood preparation before surgery led to a higher transfusion rate.
  
  
  CONCLUSIONS
  Tranexamic acid reduced blood loss in TKR and significantly reduced the blood transfusion need also when compared to fibrin tissue adhesive. The use of tranexamic acid is safe and in future may avoid preparation of autologous blood unit before surgery with a decrease of cost and medical figures involved.
authors.affiliation: Unit of Orthopaedics and Traumathology, Hospital San Luigi Gonzaga Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, Torino, Italy, luigisabatini.ort@gmail.com.
authors.forename: Luigi
authors.initials: L
authors.lastname: Sabatini
authors.forename: Francesco
authors.initials: F
authors.lastname: Atzori
authors.forename: Stefano
authors.initials: S
authors.lastname: Revello
authors.forename: Luca
authors.initials: L
authors.lastname: Scotti
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Debiasi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Massè
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D061646:Operative Time; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D015718:Fibrin Tissue Adhesive; D006454:Hemoglobins; D006490:Hemostatics; D014148:Tranexamic Acid