A Research On Topical Application Of Tranexamic Acid On Postoperative Bleeding In Total Knee Arthroplasty

Objective:To explore the efficacy and safety of reducing postoperative bleeding by articular cavity tranexamic acid (TXA) injected in total knee arthroplasty (TKA).Methods:A double-blind, randomized controlled trial of 64 patients caused by severe knee osteoarthritis(KOA) undergonging total knee arthroplasty in the Second Affiliated Hospital of Kunming Medical University from Oct 2016 to Jan 2017.Randomly divided into two groups by digital random table :experimental group(32cases),injected "cocktail therapy" 50ml with 1g TXA into articular cavity after stitched joint capsule, include 4 men and 28 women,age 52-81, average age 66.03±8.77, left side are 19 cases, right side are 13 cases. Control group(32cases),used pure "cocktailtherapy" 50ml the same way,include 3 men and 29 women,age 51-80, average age 63.84±9.47, left side are 20 cases, right side are 12 cases . Two groups were both treated with a large compreesion bandage, closed drainage tube 4h.Comparing two groups of postoperative hemoglobin(HB),hematocrit(HCT) in dayl day3 and at discharge, intraoperative blood loss,blood loss was seen after operation,dominant blood loss,blood transfusion volume,blood transfusion rate,postoperative prothrombin time(PT),activatedpartial thromboplastin time(APTT),fibrinogen(FIB), antithrombin(AT),thrombin time(TT),D-dimer(DD2),visual analogue score(VAS) in dayl, delayed healingrate,infection rate and lower extremity deep vein thrombosis(DVT) rate.Results: Blood loss was seen after operation, dominant blood loss,blood transfu-sion volume, blood transfusion rate, postoperative Hb and Hct in dayl day3 between the two groups indicated statistical significance(p<0.05);Compare two groups of Hb Hct at discharge,intraoperative blood loss,postoperative PT,APTT,FIB,AT,TT,DD2,VAS in day 1,delayed healing rate,infection rate and DVT rate has no statistical significance(p>0.05).Conclusions: Articular cavity injected topical application of TXA not only decrease the postoperative bleeding and blood transfusion rate obviously, but also doesn’t increase delayed healing rate,infection rate and DVT rate,this method is effective and safe.