title: Effectiveness and safety of tranexamic acid for total knee arthroplasty: a prospective randomized controlled trial.
abstract: BACKGROUND
  Total knee arthroplasty (TKA) is associated with significant perioperative blood loss and need for transfusion. This study aimed to evaluate the effectiveness and safety of tranexamic acid (TXA) to reduce perioperative blood loss in patients receiving TKA.
  
  
  METHODS
  A total of 92 patients who accepted unilateral TKA from May 2012 to May 2013 randomly received either 15 mg/kg TXA in 100 mL normal saline solution (TXA group, n=46) or the same amount of normal saline solution (placebo group, n=46) at 15 min before the tourniquet was loosened. The following data were recorded: intraoperative blood loss; post-operative drainage at 12 h; total drainage amount; hidden blood loss; total blood loss; transfusion volumes; number of transfusions; post-operative hemoglobin at 1, 3, and 5 days; D-dimer; number of lower limb ecchymoses; and deep vein thrombosis (DVT).
  
  
  RESULTS
  A total of 81 patients were available for analysis (TXA group, n=41; placebo group, n=40). Post-operative12-h drainage, post-operative 24-h D-dimer values, total drainage volume, hidden blood loss, total blood loss, and the rate of postoperative ecchymosis were lower in the TXA group than in the placebo group (p<0.05). The post-operative 3-day Hgb was higher in the TXA group than in the placebo group (p=0.000). The rate of transfusion and DVT was similar in both groups (n.s.).
  
  
  CONCLUSIONS
  Perioperative blood loss could be reduced after TKA by intravenously injecting 15 mg/kg TXA at 15 min before the tourniquet was loosened. The application of TXA is not associated with increased risk of DVT.
authors.affiliation: Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital, Changzhou, Jiangsu, China (mainland).
authors.forename: Peng-Fei
authors.initials: PF
authors.lastname: Shen
authors.affiliation: Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital, Changzhou, Jiangsu, China (mainland).
authors.forename: Wei-Lin
authors.initials: WL
authors.lastname: Hou
authors.affiliation: Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital, Changzhou, Jiangsu, China (mainland).
authors.forename: Jian-Bo
authors.initials: JB
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital, Changzhou, Jiangsu, China (mainland).
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Orthopedics, Changzhou Traditional Chinese Medicine Hospital, Changzhou, Jiangsu, China (mainland).
authors.forename: Yu-Xing
authors.initials: YX
authors.lastname: Qu
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D014148:Tranexamic Acid