Does Tranexamic Acid Save Blood in Minimally Invasive Total Knee Arthroplasty?

Background Tranexamic acid (TEA) reportedly reduces perioperative blood loss in TKA. However, whether it does so in minimally invasive TKA is not clear.

Questions/purposes We asked whether TEA would reduce blood loss and blood transfusion requirements after minimally invasive TKA.

Patients and Methods We prospectively enrolled 100 patients who underwent minimally invasive TKAs: 50 received one intravenous injection of TEA before deflation of the tourniquet and a control group of 50 patients received an equivalent volume of placebo. We compared changes in hemoglobin, postoperative drainage, total blood loss, and transfusion rates between the two groups.

Results The total blood loss was less for patients in the TEA group than for the control group: 833 mL (374-1014 mL) versus 1453 mL (733-2537 mL), respectively. The rate of blood transfusion also was less for patients in the TEA group than in the control group (4% versus 20%). The hemoglobin levels on the second and fourth postoperative days were greater for patients in the TEA group than in the control group.

Conclusions Our data suggest one intraoperative injection of TEA decreased the total blood loss and need for transfusion after minimally invasive TKA.

Level of Evidence Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.