Abstract:

Aim: There is no consensus on the optimal method of Tranexamic acid (TA) usage in orthopaedic surgery in the literature. The aim of this study is to evaluate the effects of single high dose (3g) topical TA application on postoperative bleeding and complications in total knee arthroplasty (TKA) surgery. Material and Methods: We retrospectively evaluated patients who underwent TKA in our clinic between January 2016 and June 2018. The patients were divided into two groups according to TA administration: Group 1 (topical TA, n=105/242) and Group 2 (non-TA, n=137/242). Demographic parameters, comorbidities, high-risk factors, preoperative hemoglobin (Hb) level, lowest postoperative Hb level, change in Hb, total drainage output, presence or absence of a transfusion, amount of blood transfused, length of stay, and complications were evaluated. Results:In group 1, postoperative first- and second-day Hb levels were significantly higher than those in group 2. The blood loss on the day of surgery, the blood loss on the first postoperative day and total drain blood loss were significantly lower in group 1. It was determined that the patients in group 2 needed significantly more blood transfusions and had more length of hospital stay. There was no statistical difference in complications between the two groups. Conclusion:Topical TA application effectively and significantly reduces blood loss and transfusion rates after surgery, without serious side effects, in patients undergoing primary TKA. This also reduces the length of the hospital stay.

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