The Effect of Tranexamic Acid in Reducing Blood Loss in Total Knee Arthroplasty

Abstract

Background: The prevalence of total knee replacement arthroplasty  is raising in number and is interrelated with significant  loss of blood, as a consequence raising in number of blood transfusion. Losing blood frequently leads to notable postsurgical anemia predisposing to higher probability for cardiorespiratory problems, Blood transfusion hazards, and elevated medical expenditure.

Objectives:  To assess the efficacy of tranexamic acid (TXA) in lowering blood loss in total knee replacement arthroplasty .

Methods: This interventional prospective study was conducted in between July 2015 and June 2017 in Combined Military Hospital (CMH), Dhaka. 48 patients of both genders with primary advanced osteoarthritis of knee, were participated in this study by giving their informed written consent for total knee replacement and insertion of cemented  prosthesis. Two doses of tranexamic acid were given to all patients through  intravenous route  .First dose(10 mg/kg) was received 10 minutes before tourniquet deflation and second same dose at 3 hours after operation.

Results: The  patients’ mean age was 62±8.12 years, female with involvement of the left knee were more. The mean blood loss was 368.75 ±46.53 ml in the study group. This result is much lower compairing with other studies what they have mentioned.The mean deduction of haemoglobin concentration (gram/dl) amidst before and after surgery  account was 1.66 ±0.27 gram/dl.

Conclusion: The administration of  tranexamic acid through intravenous route in total knee replacement arthroplasty decreases loss of  blood  in postsurgical periods. Regarding requiring blood transfusions due to  total blood loss and reduction in haemoglobin level, we strongly recommend for  the use of tranexamic acid through  intravenous route routinely during total knee replacement arthroplasty since it was safe with no extra side effects .

Bangladesh Armed Forces Med J Vol 58 No (2) December 2025, pp 29-37