Control of perioperative blood loss is important in total knee arthroplasty (TKA), especially cementless or hybrid TKA. There is increasing interest in the use of tranexamic acid (TXA) for this purpose, however, studies to date have mainly evaluated the effects of various TXA administration regimens on patients who have undergone cemented TKA. We sought to determine (1) whether administration of TXA reduces blood loss after hybrid TKA, and (2) whether an autologous blood reinfusion system is necessary in TKA patients who are treated with TXA.

Ninety-five patients (100 knees) who underwent hybrid primary TKA (cemented tibia, uncemented femur) were included in this study. The initial 50 knees were treated without TXA and the following 50 were treated with TXA. Intravenous TXA (1000 mg) was administered shortly before deflation of the tourniquet. All continuous variables were expressed as median values.

Total volumes of blood lost at postoperative 1 day were 590 mL and 150 mL and autotransfusion of collected blood was performed in 88% and 16% of patients in the without and with TXA groups, respectively. A median volume of 400 mL of collected blood was returned to the patients in the without TXA group, and 0 mL to the patients in the with TXA group. The calculated volumes of blood lost were 761 mL and 683 mL (p = 0.2250), respectively.

One intravenous injection of 1000 mg TXA may help to control postoperative blood loss and reduce the need for postoperative autologous blood reinfusion after hybrid TKA.

Level II.