The Effect And Safety Of Different Doses Of Tranexamic Acid On Perioperative Blood Loss In Patients Of Unilateral Total Knee Arthroplasty

ObjectiveTo investigate the efficacy and safety of different doses of tranexamic acid on perioperative blood loss associated with unilateral total knee arthroplasty.Methods From July2012to July2013,142patients, who received TKA because of osteoarthritis, were in criteria. The patients were divided into three groups according to a random number table generated by a software (Microsoft Office Excel2003; Microsoft Corp., Seattle, USA).Every group takes48,48and46cases respectively. Patients in Group A received only glucose injection, in Group B received0.75g tranexamic acid and in Group C received the concentration two-time higher. The blood loss, total and hidden, was calculated. The blood loss, intraoperative and external, and the number of the patients administrated blood transfusion were recorded. Prothrombin time. PT-INR, activated partial thromboplastin time and D-dimer were examined before and3hours after operation. Doppler ultrasonography5days after operation and a three-month follow-up program were applied to determine deep vein thrombosis.ResultsThere were significant differences in the amount of total blood loss, external blood loss,the number of the patients needing blood transfusion and the value of D-dimer concentration among three groups (P<0.05).In group B and C, all the four mentioned data became significantly lower. There was no significant difference in intraoperative blood loss, hidden blood loss among three groups(P>0.05). There were also no significant difference in the levels of APTT, PT-INR,and PT among three groups (P>0.05). And no deep vein thrombosis was found5days and3months after operation.ConclusionIn thirty minutes before the deflation of the tourniquet of a TKA operation, a short-term use of tranexamic acid can significantly decrease total blood loss, external blood loss and the number of the patients needing blood transfusion, and double-concentration group hasbetter outcome while the rate of venous thrombosis remains the same. However,tranexamic acid had little influence on hidden blood loss.