We conducted a retrospective study to compare the blood loss following Primary Total Knee Replacement (TKR) to see effectiveness of Tranexamic acid (TXA).v/s Cell Salvage.

This was a retrospective study conducted from Aug 2008 to Dec 2009. We compared two groups. Group A was given TXA IV (two doses – first dose before tourniquet release and second dose six hours post-operative) and in group B post op cell salvage was used. 84 knees were included in this study with 42 patients in each group. The surgical technique, implants used and post-operative Thromboprophylaxis care were same in both groups.

The corrected mean Hob drop in Group A was 1.76g/dl (Range-0.7 to 4.3) while that in Group B was 2.32g/dl (Range-0.7 to 5.3). Use of TXA lead to a 24.13% decrease in mean Hob drop and 3.7% fall in mean drain output following TKR in our study. Two thromboembolic events in the form of deep vein thrombosis (DVT) confirmed by Duplex US scan, were noted in each group. There was no difference in complication rate i.e. drain site infection and wound leaking in either group. Costs - The cost of two doses of TXA is £3.81 per patient and cost of bellovac drain was £85 per patient.

We found TXA was more effective and cheaper than autolougus blood transfusion and there was no increase in thromboembolic complications