Intraarticular Tranexmic Acid Reduces Need for Blood Transfusion in both Knee and Hip Arthroplasty

Introduction: Knee and hip replacement are very successful and popular treatment for osteoarthritis leading to pain relief, improved range of motion and reincorporation to daily life activities. One of the problems following surgery is postoperative blood loss anemia with need of blood transfusions.
Use of Tranexamic Acid(TXA), either intravenous, intraarticular or oral, following knee and hip replacement surgeries have emerged as a viable treatment for blood loss prevention.

Materials and Methods: We present a retrospective case control study comparing two groups of patients with primary osteoarthritis how underwent total knee replacement (TKA) or total hip replacement (THA) during 4 months period in two consecutive years (2015 and 2016) in our institution with patients with the same characteristics. The first group from 2015 was not treated with TXA while patients in the second group all received 2 Grams of intraarticular TXA.

Criteria for blood transfusion did not change between the two groups and consisted of Hb level under 8gr% or clinically symptomatic anemia.

Results: Significant decrease in the blood transfusion rate was noted. In the THA from 15.47% to 4%(p 0.042) of the patients. In case of the TKA from 18.75% to2.94% (p 0.003) of the cases. Venous thromboembolic events did not differ between the groups.

Conclusion: Routine use of intraarticular tranexamic acid is useful in reducing need for blood transfusions after hip and knee replacement surgery.