European Journal of Cardiovascular Medicine

Background: The application of tranexamic acid (TXA) in total hip arthroplasty (THA) and total knee arthroplasty (TKA) has brought momentous changes in blood management. However, the optimal regimen of TXA has not yet been identified. This study aimed to compare the efficacy of a three-day prolongedcourse of multiple-dose of TXA with a single pre-operative dose of TXA in patients who undergo THA and TKA. Peri-operative blood management practices for elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) have been revolutionized by the application of tranexamic acid (TXA) over the past decade. There is a wealth of evidence in the literature demonstrating that the routine use of TXA in total joint arthroplasty (TJA) can significantly reduce peri-operative blood loss, the transfusion rate, inflammatory responses, the post-operative swelling ratio, and the need for routine post-operative blood tests; and without an evident increase in the risk of thromboembolic events.  Materials and methods: This is a prospective study was conducted in the Department of Orthopedics and Pharmacology in a Tertiary Care Teaching Center over a period of 1 year. Inclusion criteria were patients aged over 18 years who had underwent primary or revision unilateral or bilateral THA and TKA. Participants were divided into 2 groups; those had received pre or postoperative intravenous or intra-particular TXA (group 1) and those who had received no-TXA although it was not contraindicated (group 2). Patients were excluded if they are allergic to TXA, had previous thromboembolic events, coagulopathies and bleeding disorders. Result: A total of n=60 patients underwent THA and TKA during the study period and were eligible for inclusion in the study. N=29 patients in the group were given Tranexamic Acid prior to the commencement of surgery after spinal anesthesia, and n=31 patients were not given Tranexamic acid. The mean age of patients in Tranexamic Acid Group [TXA group] is 62.45±14.88 and the Control Group is 62.28±14.35. The difference between the two groups was not statistically significant (P = 0.973). The sex distribution among TXA Group and Control Group was comparable and there was no significant difference 0.09. Conclusion: Tranexamic acid use in TKA and THA is effective in reducing post-operative blood loss in terms of drop in Hg level, total drainage output and blood transfusion rate. TXA use in total hip and knee arthroplasty as intravenous or intraarticular administration appears to be effective and recommended to reduce postoperative blood loss in terms of drop in hemoglobin level, total drainage output and the need for blood transfusion.