Abstract
Aim
To investigate the effect of Tranexamic acid on blood loss associated with Total Knee Replacement Surgery.
Methods
A prospective double blind randomised controlled trial was conducted on 48 patients undergoing unilateral primary cemented total knee replacement. The mean age of the patients was 68 years. Recruitment was based on specific inclusion and exclusion criteria. Patients were randomised to receive either 10 mg/kg of tranexamic acid or a similar volume of normal saline at the time of cementing the prosthesis before deflation of the tourniquet. Both the patient and the surgeon were blinded to the type of injection. The post-operative blood loss was calculated in each case.
Results
A statistically significant decrease in blood loss was noted at four (p=0.002) and eight hours (p=0.043) after knee replacement in the group receiving tranexamic acid. However there was no significant difference in total blood loss (p=0.09) at 24 hours between the two groups.
Conclusion
Intra-operative administration of Tranexamic acid reduces blood loss after knee replacement surgery. The maximum reduction occurred in the first four hours after surgery, an effect likely to be related to the half life and minimum effective concentration of Tranexamic acid in the plasma. This study suggests that additional doses of tranexamic acid in the post-operative period may help to further reduce blood loss. However further study is needed to assess the safety and efficacy of prolonging this treatment.
