Clinical and financial benefits of intra-articular tranexamic acid in total knee arthroplasty.
To determine whether intra-articular tranexamic acid (TXA) use after total knee arthroplasty (TKA) results in decreased postoperative blood transfusion and length of hospital stay.



Medical records of 1981 patients (mean age, 69.2 years) who underwent primary TKA with (n=1006) or without (n=975) TXA use by any of 4 knee arthroplasty surgeons were reviewed. TXA (3000 mg/30ml) was administered via an epidural catheter into the knee joint after wound closure. Postoperative blood transfusion was given to patients with haemoglobin (Hb) level <80 g/dl on days 1 and 2 or with symptoms of acute anaemia.



Intra-articular TXA use after TKA resulted in a lower blood transfusion rate (4.5% [45/1006] vs. 14.8% [144/975], p<0.0001), fewer units of blood transfused (86 vs. 313 units, p<0.0001), fewer units of blood transfused per 100 patients (8.5 vs. 32.1, p<0.0001), and shorter length of hospital stay (4.7±2.3 vs. 5.3±2.7 days, p<0.0001). Total cost savings with respect to the reduction in blood transfusion was AU$143.68 per patient. When the change in length of hospital stay and TXA costs were included, the overall saving was AU$631.36 per patient.



Intra-articular TXA use can reduce costs as a result of decreased blood transfusion rate and length of hospital stay in patients undergoing TKA.
Sydney Knee Specialists, Australia.
N
N
Goyal
Sydney Knee Specialists, Australia.
D B
DB
Chen
Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Australia.
I A
IA
Harris
St George Knee Clinic, Kogarah, NSW, Australia.
N
N
Rowden
St George Private Hospital, Kogarah, NSW, Australia.
G
G
Kirsh
Sydney Knee Specialists, Australia.
S J
SJ
MacDessi
D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019645:Arthroplasty, Replacement, Knee; D001803:Blood Transfusion; D017046:Cost Savings; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
arthroplasty, replacement, knee; blood loss, surgical; cost-benefit analysis; tranexamic acid