TOTAL KNEE ARTHROPLASTY?;

POST OPERATIVE MEAN BLOOD LOSS WITH TRANEXAMIC ACID, IS TRANEXAMIC ACID EFFECTIVE IN REDUCING BLOOD LOSS. A RANDOMIZED CONTROLLED TRIAL IN TERTIARY CARE HOSPITAL, PAKISTAN.

Abstract

The treatment of choice for osteoarthritic knee is Total knee arthroplasty (TKA)
and the most important problem in it is the blood loss. Objectives: To compare the postoperative
mean blood loss with Tranexamic acid versus control after Total Knee Arthroplasty.
Study Design: Randomized controlled trial. Setting: Ghurki Trust Teaching Hospital Lahore.
Period: 01 year. Methodology: 100 patients were included and divided in 2 groups, selected
by non-probability purposive sampling, fulfilling inclusion and exclusion criteria. Group T
(Tranexamic) received 15mg/kg IV Tranexamic acid 10 minutes before inflating tourniquet and
the same dose intravenously 3 hours post-operatively. Group C (control) received placebo
(normal saline) intravenously. Blood loss collected in a container was measured with syringe/jar
after 24 hours of surgery. Results: In group C there were 23(46%) males and 27(54%) females
with male to female ratio 1:1.7 with mean age of 64yrs ± 6.3 yrs. In group T there were 28(56%)
males and 22 (44%) females with male to female ratio 1.2:1 with mean age of 65yrs ± 7.4 yrs.
After 24 hours Mean blood loss in Group C were 694 ±151 ml with 74 % patient in range of
600-900ml while Mean blood loss in Group T were 388 ml ±105 ml with 76 % patient in range
of 300-600ml. Mean decrease in blood loss with the use of tranexamic acid { mean blood loss
in T group – mean blood loss in T group } were 306 ml which were statistically significant(p<
0.05) using t Test. Conclusion: Tranexamic acid is a potent anti-fibrinolytic agent and its use in
total knee arthroplasty results in decrease in post-operative blood loss thereby decreasing the
need of blood transfusion.