Efficacy of a Single Dose and an Additional Dose of Tranexamic Acid in Reduction of Blood Loss in Total Knee Arthroplasty

Background: This study aimed at evaluating the efficacy and safety of different regimens with a single dose and an additional postoperative dose of tranexamic acid (TA) in reducing blood loss in total knee arthroplasty (TKA). Methods: A total of 180 patients who were scheduled to undergo primary unilateral TKA in our level I trauma center were recorded and divided into groups A, B, C, and D randomly. Preoperative dose, an additional postoperative dose, and 2 postoperative additional doses of TA were infused intravenously in groups A (30 mg/kg), B (15 mg/kg), and C (10 mg/kg), respectively, and TA was not infused in group D. Blood loss (intraoperative, postoperative, and total blood loss), blood transfusion rate and volume, hemoglobin level, and incidence of deep vein thrombosis were analyzed. Results: The total blood loss and postoperative blood loss were significantly lower in groups B and C without any difference between them. As for intraoperative blood loss, there was no significant difference between groups A and B and between groups B and C with superior efficacy than group D. Conclusion: With the same total dose of TA, the preoperative dose and an additional dose of TA were superior to a single preoperative dose of TA in reducing blood loss in TKA. Besides, 1 additional dose was comparable to 2 additional doses of TA in reducing blood loss. (C) 2016 Elsevier Inc. All rights reserved.