Comparison Of Three Applications Of Tranexamic Acid In Reducing Blood Loss In Total Knee Arthroplasty And Its Safety Analysis

Objective:The propose of this research is to investigate the hemostatic effectiveness of three different administrations of tranexamic acid in total knee arthroplasty.In order to explore the best application of tranexamic acid in TKA.Method: In this retrospective case-control study we record demographic characteristics?preoperative blood test date?postoperative blood loss ? hemoglobin level ? postoperative complication and thromboembolic events.In Intravenous Group,the dose of 15mg/kg of TXA were infused intravenously 15 minutes before loosening tourniquet.In Topic Group,the dose of15mg/kg of TXA diluted in 20 mL normal saline applied through drainage tube after closure.In Combined Group,the half dose of 15mg/kg of TXA were applied intravenously15 minutes before loosening and the last dose of 15mg/kg of TXA diluted in 20 mL normal saline applied through drainage tube after closure.Results: There were no significant differences in the amount of drainage within 24 h postoperatively(P>0.05).The total blood loss?the hidden blood loss and hemoglobin drop in combined group significant lower than Intravenous Group and Topic Group,(P < 0.05).There were 4 patients occurred respectively plexus venosus leg muscle thrombosis in Intravenous Group and Topic Group.There were 2 patients occurred plexus venosus leg muscle thrombosis in Combined Group.There were no PE events in all patients,(P>0.05).Conclusion: Combined Group seems to be more effective in terms of reducing the total blood loss?the hidden blood loss and hemoglobin drop in TKA.There were no significant differences of VTE events in three groups.