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Topical, intravenous tranexamic acid offer similar efficacy during TKA
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For patients undergoing unilateral primary total knee arthroplasty, topical tranexamic acid had similar efficacy to intravenous tranexamic acid, according to study results.
Researchers randomly assigned 89 patients undergoing unilateral primary total knee arthroplasty to receive one intravenous 10 mg/kg dose of tranexamic acid (TXA) 10 minutes prior to tourniquet deflation or 2 g TXA in 100 mL of normal saline directly into the surgical site and bathed in the solution for 2 minutes prior to tourniquet release. Primary outcome measure was the difference between preoperative hemoglobin and lowest postoperative hemoglobin during the hospital stay, and secondary outcomes included a comparison of preoperative hemoglobin, postoperative hemoglobin, total drain output, anesthesia method, approach to surgery, tourniquet time, American Society of Anesthesiologists physical status scores, transfusion rates, rate of deep vein thrombosis/pulmonary embolism and associated perioperative complications.
With regard to patient demographics or perioperative function, study results showed no differences between the intravenous TXA group and the topical TXA group.
The researchers found a decrease in perioperative change in hemoglobin level of 3.06 in the intravenous group compared with 3.42 in the topical group.
Overall, no statistical differences were found between the groups in preoperative hemoglobin level, lowest postoperative hemoglobin level or total drain output, and only one patient required blood transfusion in the topical group, according to the researchers.
Disclosures: Huang is on the editorial board for the Journal of Spine. Malkani received royalties from, is on the speaker’s bureau and is a paid consultant for Stryker; he also received research support from Synthes and Stryker and is on the editorial board for the Journal of Arthroplasty.
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