Prospective Study to compare Intra-articular versus Intravenous Tranexemic Acid in reducing Post-operative Blood Loss in staged bilateral Total Knee Arthroplasty

Journal Title: Malaysian Orthopaedic Journal - Year 2016, Vol 10, Issue 3

Abstract

The number of total knee arthroplasties (TKA) performed is around two million annually worldwide and this number is expected to increase fivefold by 2025. The most common indication is osteoarthritis of the knee. Blood loss is significant during the post-operative period and blood transfusion when necessary has its own drawbacks. The use of intravenous tranexamic acid has significantly reduced blood loss. We analysed 35 patients who underwent staged bilateral TKA between August 2013 and February 2016 and had administered intra-articular tranexamic acid for one knee and intravenous tranexamic acid for the other knee. The results were analysed based on post-operative blood loss, change in haemoglobin (Hb) level and haematocrit (PCV) and the need for blood transfusion. The average postoperative blood loss was 129.57 ml and 277.71 ml for intra articular group and intravenous group respectively. A control group (no drug or placebo group) with age matched patients (n= 21) was chosen from medical records. The average blood loss in the control group was 493.81 ml. The fall in Hb level and PCV was 0.72 gm/dl and 2.62 % (Intra-articular Group), 1.36 gm/dl and 4.34 % (Intravenous Group) and 2.62 gm/dl and 5.52 % (Control). The number of transfusions were two (Intra-articular Group), five (Intravenous Group) and nine (Control). We conclude that when compared with intravenous route, intra-articular administration has significantly reduced blood loss, Hb level and PCV fall and the rate of blood transfusion.

Authors and Affiliations

Balasubramanian N, Natarajan GB, Prakasam S

Keywords

Related Articles

Being Mortal: Illness, Medicine and What Matters in the End Atul Gawande 2014

This book describes what patients go through when they become ill and the options available when they can no longer care for themselves. The traditional nursing home where residents live a regimented life is in stark con...

Endoscopic Carpal Tunnel Release – A Prospective Study of Functional Outcome

To evaluate the functional outcome of patients who underwent endoscopic carpal tunnel release (ECTR). This was a prospective study in 24 patients with idiopathic carpal tunnel syndrome undergoing ECTR . Patient assessmen...

Common Mistakes in Manuscripts Submitted for Publication

We prefer articles that are short and focused. An extensive review of the literature on a subject are for review articles and it is not the main purpose for publishing original studies or case reports. Well prepared arti...

Cortical Blindness In Fat Embolism Syndrome Following Fracture Manipulative Procedure

Fat embolism syndrome is a well-recognised sequela of long bone trauma as well as intramedullary orthopaedic procedures. However, it has rarely been described following manipulation, reduction of fracture, and applicatio...

Retained Intraspinal Bullet: A Rare Case in a Visitor to Malaysia - A Case Report

Firearm injuries to the spine commonly present with acute neurology caused by direct penetration or indirectly from concussive effects of bullet impact on the vertebral column. We report a case of delayed neurologic pres...

Download PDF file
  • EP ID EP309994
  • DOI 10.5704/MOJ.1611.020
  • Views 52
  • Downloads 0

How To Cite

Balasubramanian N, Natarajan GB, Prakasam S (2016). Prospective Study to compare Intra-articular versus Intravenous Tranexemic Acid in reducing Post-operative Blood Loss in staged bilateral Total Knee Arthroplasty. Malaysian Orthopaedic Journal, 10(3), 7-11. https://europub.co.uk/articles/-A-309994