JOURNAL ARTICLE
OBSERVATIONAL STUDY
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Periarticular Injection of Tranexamic Acid Reduces Blood Loss and the Necessity for Allogeneic Transfusion After Total Knee Arthroplasty Using Autologous Transfusion: A Retrospective Observational Study.

BACKGROUND: This study aimed to examine the influence of a periarticular injection of tranexamic acid (TXA) on blood loss after a total knee arthroplasty (TKA) in patients who received an autologous blood transfusion.

METHODS: We retrospectively reviewed the medical charts of 82 patients (88 consecutive knees) who underwent a primary unilateral TKA with or without a periarticular TXA injection (TXA and control groups, respectively). All patients underwent an autologous blood transfusion. Perioperative parameters related to blood loss were compared between groups.

RESULTS: Compared to the control group, the decrease in hemoglobin was significantly smaller in the TXA group (1.5 ± 1.2 vs 2.5 ± 1.4 g/dL, P < .001), and blood drainage was significantly lower in the TXA group (387.2 ± 215.7 vs 582.3 ± 272.9 mL, P = .002). Moreover, the estimated blood loss, based on either hemoglobin or hematocrit, was significantly lower in the TXA group (509.8 ± 405.2 and 530.7 ± 418.5 mL, respectively) than in the control group (814.2 ± 543.8 and 809.1 ± 469.6 mL, respectively, both P < .001). No severe complications, including a venous thromboembolic event or infection, or local complications, including skin necrosis or delayed wound healing, were observed in either group. A postoperative allogeneic blood transfusion was performed in 2 cases in the control group and none in the TXA group.

CONCLUSION: Periarticular TXA injection is effective in reducing postoperative blood loss and hemoglobin and hematocrit drops without increasing the risk of venous thrombosis or the necessity of an allogeneic blood transfusion.

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