title: [Single intravenous tranexamic acid dose to reduce blood loss in primary total knee replacement].
abstract: OBJECTIVE
  To evaluate the effectiveness and safety of a single intravenous dose of tranexamic acid in order to reduce blood loss in total knee replacement.
  
  
  METHODS
  Prospective observational study of the administration of tranexamic acid in patients undergoing primary total knee arthroplasty from November 2013 to February 2015, in which an autologous blood recovery system was used. The study included 98 patients, distributed into two groups of 49 patients according to whether or not they received intravenous tranexamic acid. The primary endpoint was the number of patients requiring autologous transfusion from the recovery system autologous blood recovery system.
  
  
  RESULTS
  No drop-outs were recorded during follow-up. There were no significant differences between groups as regards the preoperative and hospital variables. The mean preoperative haemoglobin and haematocrit at 24 and 48 hours postoperatively were similar in both groups. The average volume of bleeding in the autologous blood recovery system and estimated average blood loss was lower in patients who had been administered tranexamic acid, with significant differences. No patients in the group that was administered tranexamic acid required blood autotransfusion. The transfusion rate was zero in the two groups. No adverse events related to the administration of tranexamic acid were recorded.
  
  
  CONCLUSIONS
  Intravenous administration of tranexamic acid, according to the described protocol, has presented a non-autotransfusion or allo-transfusion rate of 100%, with no increased incidence of thrombotic events. Thus, its use in this group of patients is recommended. The indication should be individualized, its use justified in the patient medical records, and informed consent is mandatory.
authors.affiliation: Servicio de Cirugía Ortopédica, Hospital Universitario Sant Joan d'Alacant, Alicante, España. Electronic address: javisanz@coma.es.
authors.forename: J
authors.initials: J
authors.lastname: Sanz-Reig
authors.affiliation: Servicio de Cirugía Ortopédica, Hospital Universitario Sant Joan d'Alacant, Alicante, España.
authors.forename: B
authors.initials: B
authors.lastname: Parra Ruiz
authors.affiliation: Servicio de Cirugía Ortopédica, Hospital Universitario Sant Joan d'Alacant, Alicante, España.
authors.forename: J
authors.initials: J
authors.lastname: Ferrández Martínez
authors.affiliation: Servicio de Cirugía Ortopédica, Hospital Universitario Sant Joan d'Alacant, Alicante, España.
authors.forename: J F
authors.initials: JF
authors.lastname: Martínez López
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001804:Blood Transfusion, Autologous / Q000706:statistics & numerical data; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: Bloodless surgery; Cirugía sin sangre; Prótesis total rodilla; Total knee replacement; Tranexamic acid; Ácido tranexámico