Peri-articular Tranexamic Acid Injection in Total Knee Arthroplasty

Peri-articular Tranexamic Acid Injection in Total Knee Arthroplasty: A Randomized Controlled Trial

This study evaluates the peri-articular tranexamic acid injection in total knee arthroplasty which is an alternative route of administration for blood loss reduction. Half of participants will receive intravenous tranexamic acid injection, while the other half will receive peri-articular tranexamic acid injection during total knee arthroplasty.

Intravenous tranexamic acid (IV TXA) is one of the most effective agents in use for reducing blood loss following total knee arthroplasty (TKA) but its safety regarding venous thromboembolic events (VTEs) remains in question. The direct, local application of TXA may reduce systemic toxicity whilst maintaining good or better bleeding control compared to IV TXA. The topical application of TXA via Hemovac drains has been reported previously with good results. However, there are no data on peri-articular TXA injections during TKA.

Inclusion Criteria:

• adult patients with osteoarthritis in need of a TKA

Exclusion Criteria:

• inflammatory arthritis
• post-traumatic arthritis
• a history of or current venous thromboembolic disease
• any underlying disease of haemostasis
• cirrhosis
• chronic renal failure
• patients on anticoagulants or strong antiplatelet drugs (e.g. warfarin, clopidogrel)
• know allergy to TXA
• defective color vision
• preoperative hemoglobin <10 g/dL
• platelet count < 140,000 /uL3