Abstract Background: Total knee arthroplasty (TKA) is associated with considerable perioperative blood loss, often requiring blood transfusion. Tranexamic acid (TXA) is commonly used to reduce bleeding; however, the optimal dosing regimen remains unclear. Aim: This study aims to compare the effectiveness and safety of three TXA regimens in reducing perioperative blood loss following unilateral primary TKA. Materials and Methods: This retrospective observational study included 99 patients who underwent unilateral primary TKA between January 2013 and March 2015. Patients were equally divided into three groups ( n = 33 each). Group A received intravenous TXA 10 mg/kg preoperatively with topical TXA (IV10+ topical). Group B received an additional postoperative intravenous dose of 10 mg/kg (IV10 pre + post + topical). Group C received intravenous TXA 15 mg/kg preoperatively with topical TXA (IV15+ topical). The primary outcome was total blood loss calculated using the hemoglobin balance method up to postoperative day (POD) 5. Secondary outcomes included drain output, hemoglobin reduction, transfusion requirement, and thromboembolic complications. Results: Baseline demographic and operative variables were comparable among groups ( P > 0.05). Mean total blood loss till POD-5 was similar across all regimens ( P = 0.52). Postoperative drain output, hemoglobin drop, and transfusion requirements showed no significant differences. No thromboembolic complications were observed. Conclusion: All TXA regimens were safe and effective in reducing blood loss following TKA. Higher intravenous dosing or additional postoperative administration did not offer advantages over the standard IV10+ topical regimen, which appears to be the most practical and cost-effective approach.
Maniar et al. (Thu,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: