Bilateral total knee arthroplasty (TKA) results in substantial perioperative blood loss with increased morbidity. Tranexamic acid (TXA) administration in either intravenous or topical form has been found to be effective in reducing perioperative blood loss. The objective of the present study was to compare the efficacy of topical versus intravenous TXA in reducing perioperative blood loss. Prospective, randomized, double-blinded clinical trial was carried out on 70 patients undergoing bilateral TKA, who were divided into two groups. Group I received equivalent dose of TXA intravenously 30 minutes prior to deflation of tourniquet of first knee and another dose repeated after 2 hours. Group 2 received topical TXA in the dose of 15mg/kg dissolved in100 ml of normal saline which was applied into the joint for 10 minutes at the end of implant insertion. Outcome measures were total blood loss as (calculated from the difference between preoperative and postoperative day3 haemoglobin (Hb) or Hb prior to transfusion), total drain output and amount of blood transfusion.Introduction
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