The Knee, ISSN: 1873-5800, Vol: 19, Issue: 4, Page: 295-8

Reducing blood loss in primary knee arthroplasty: A prospective randomised controlled trial of tranexamic acid and fibrin spray

McConnell, Jamie S; Shewale, Sandeep; Munro, Niall A; Shah, Kalpesh; Deakin, Angela H; Kinninmonth, Andrew W G
Knee
A prospective, randomised controlled trial compared the effects of two medications intended to reduce blood loss from total knee arthroplasty. Patients were randomised to one of the following three treatment groups: 10 mg/kg tranexamic acid at given at induction of anaesthesia, 10 ml of fibrin spray administered topically during surgery, or to a control group receiving neither treatment. Sixty six patients underwent elective cemented total knee arthroplasty; computer navigation was used in all cases.
There was no significant difference in blood loss between the tranexamic acid and fibrin spray groups (p = 0.181). There was no significant difference in blood loss between the tranexamic acid and fibrin spray groups(p=0.181). The fibrin spray led to a significant reduction in blood loss compared to control (p=0.007). The effect of tranexamic acid did not reach significance (p=0.173). We conclude that fibrin spray was effective in reducing blood loss but that with a study of this power, we were unable to detect an effect of tranexamic acid in cemented navigated total knee replacement at the dose used.

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