title: The role of tranexamic acid in reducing blood loss in total knee replacement.
abstract: BACKGROUND
  Total knee arthroplasty is associated with significant perioperative blood loss which may necessitate blood transfusion. In this prospective randomised case control study we analysed the efficacy and safety of tranexamic acid in reducing perioperative blood loss and requirement of blood transfusion in total knee arthroplasty.
  
  
  METHODS
  Fourteen patients (group A) undergoing total knee replacement were given intravenous tranexamic acid twice, once ten minutes before tourniquet deflation and once after four hours. Thirteen patients (group B) were observed as a separate group without the administration of the drug. Total perioperative blood loss, need of blood transfusion and D-dimer assay were analysed subsequently.
  
  
  RESULTS
  The average blood loss in the first group was 266.2 ml and in the second group was 667.5 ml (p < 0.001). average requirement of transfusion in both the groups were 0.54 and 1.6 units of blood respectively (p < 0.001). There was no case of deep vein thrombosis or any other untoward effects.
  
  
  CONCLUSIONS
  Hence from these evidences it was concluded that administration of tranexamic acid during total knee replacement helps to reduce blood loss without increasing the risk of deep vein thrombosis.
authors.affiliation: Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India.
authors.forename: Virender Kumar
authors.initials: VK
authors.lastname: Gautam
authors.affiliation: Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Sambandam
authors.affiliation: Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India.
authors.forename: Shailendra
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India.
authors.forename: Prince
authors.initials: P
authors.lastname: Gupta
authors.affiliation: Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India.
authors.forename: Rajat
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Department of Orthopaedic Surgery, Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India.
authors.forename: Lalit
authors.initials: L
authors.lastname: Maini
keywords: Blood loss; Total knee replacement; Tranexamic acid