Reduction of blood loss after total knee arthroplasty by tranexamic acid

Background: Total knee arthroplasty is associated with significant peri-operative blood loss. Various studies have shown that the use of tranexamic acid reduces post-operative blood loss and need for allogeneic blood transfusion in total knee arthroplasty.  Objectives: To assess the effect of tranexamic acid in the reduction of the postoperative blood loss in total knee arthroplasty. Methodology: An analytical cross-sectional study was carried out in 14 patients who underwent primary total knee arthroplasty during the study period of 12 months at Kathmandu Medical College. Seven patients were allocated to the case group and received one gram (gm) of tranexamic acid thirty minutes prior to the incision and five hundred milligram (mg) orally three times a day till the drain was removed. Tranexamic acid was not given to the seven patients in control group. The haemoglobin of the patient was recorded on the day of surgery and the total amount of drain output was recorded on postoperative period until the drain was removed. Results: Out of 14 patients operated, it was found that the average amount of drain in the patients in case group was 628 ± 234 millilitre (ml) which was significantly lower than the control group 1028 ± 183  ml (p<0.05). Though there was a difference in the amount of drain output, there was no significant change in the postoperative haemoglobin level in both the groups (p = 0.381).  Conclusion: Tranexamic acid, an antifibrinolytic agent, can be effective to reduce blood loss in patients who undergo major surgeries like total knee arthroplasty.