Introduction Total knee arthroplasty alleviates pain and restores function in patients with osteoarthritis of the knee, but it is associated with postoperative blood loss resulting in anemia and allogeneic blood transfusion in 10% to 38% of patients.
Step 1: Prepare Solution Prepare tranexamic acid solution using aseptic technique.
Step 2: Apply SolutionApply tranexamic acid solution to the open joint and soft-tissue surfaces.
Step 3: Remove Solution and CloseRemove tranexamic acid, keeping the tourniquet inflated until the wound is closed and the dressing is applied.
Results & Preop./Postop. Images We showed, in a prospective, double-blinded, placebo-controlled randomized trial, that topical application of tranexamic acid directly into the surgical wound prior to closure at the end of a total knee arthroplasty reduces postoperative bleeding by 20% to 25%, or 300 to 400 mL.
What to Watch For Indications
Pitfalls & Challenges
Total knee arthroplasty alleviates pain and restores function in patients with osteoarthritis of the knee, but it is associated with postoperative blood loss resulting in anemia and allogeneic blood transfusion in 10% to 38% of patients1,2. Currently available blood conservation modalities to reduce the need for allogeneic blood transfusion do not reduce the amount of intraoperative blood loss or prevent the postoperative reduction in hemoglobin level. Preoperative autologous blood donation is costly; does not eliminate the risks of clerical errors or bacterial contamination; and may be unused, leaving patients anemic3. Intravenous administration of the antifibrinolytic agent tranexamic acid has been shown to reduce postoperative bleeding and the need for transfusion4,5. Tranexamic acid is a synthetic antifibrinolytic drug that prevents the breakdown of fibrin (the primary component of blood clots), thereby stabilizing blood hemostasis and reducing blood loss under conditions that promote fibrinolysis6. Increased fibrinolysis can result …
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