Comparison of Intra-articular versus Intravenous Application of Tranexamic Acid in Total Knee Arthroplasty: A Prospective Randomized Study

Background: Total knee arthroplasty (TKA) is commonly performed for the advanced knee joint disease. Considerable postoperative blood loss, however, is an unavoidable occurrence because of extensive soft-tissue release, and the large area of cancellous bone osteotomy associated with the procedure. In addition, knee flexion and extension activities that begin the day after the operation adds to the problem. Aim of the Work: to compare between the intravenous the intraarticular tranexamic acid (TXA) administration in total knee arthroplasty surgery. Patients and Methods: It is a prospective double-blinded randomized controlled study. This prospective, two-arm, parallel-group study was conducted at El-Hussein University Hospital and El-Agouza Hospital on 20 patients who underwent total knee arthroplasty and fulfilled all assumed inclusion and exclusion criteria. Results: The average total blood loss amount in the drain after 48 hrs. in the 1st group was 365±74.722 while in the 2 nd group it was 575±88.976. This indicates a significant decrease in blood loss amount in the 1st group (intraarticular TXA group) than the 2 nd group (intravenous TXA group). Also, it was found that the decrease in hemoglobin (Hb) level is less in the 1st group than in the 2nd group which indicates less postoperative anemia. Conclusion: Concerning intraarticular administration of TXA seemed to be effective much more than intravenous injection in terms of blood loss amount and transfusion frequency.