Effectiveness of intraoperative use of tranexamic acid in total knee arthroplasty

Background: Blood loss is among the commonly encountered problems in total knee arthroplasty (TKA) surgeries. Tranexamic acid (TXA) is commonly used intravenously to decrease the blood loss during TKA. However, it has got its own contraindications. In such patients, it can also be used locally to prevent blood loss. We assessed the effectiveness of local TXA by determining the amount of blood loss and transfusion required. Materials and Methods: A total of 60 patients with 72 TKA surgeries were included and analyzed in this observational prospective study. Three Gram of TXA was infiltrated locally into the tissues immediately after skin closure before the release of the tourniquet. The amount of blood loss was calculated by comparing the preoperative and postoperative hemoglobin (Hb) levels. Results: The mean blood loss in patients whom local TXA was used was 433.3 ml. The mean postoperative Hb loss was 1.01. Only one patient with bilateral TKA required postoperative blood transfusion. There were no issues with wound healing in any of our patients. The P value in Hb loss was 0.002 and in total blood was 0.001 and were statistically significant. Conclusion: Local use of TXA is very effective in reducing the amount of postoperative blood loss and the need for the blood transfusion. We recommend for the local use of TXA in primary knee arthroplasty surgeries.