Efficacy of Tranexamic Acid in Reducing Blood Loss and Transfusion Requirements in Primary Total Knee Arthroplasty: A Prospective Comparative Study.

INTRODUCTION

Total knee arthroplasty (TKA) is associated with significant perioperative blood loss, often necessitating blood transfusion. Tranexamic acid (TXA), an antifibrinolytic agent, has been shown to reduce bleeding effectively. This study evaluated the efficacy and safety of intravenous TXA in reducing perioperative blood loss in patients undergoing primary unilateral TKA.

MATERIALS AND

METHODS

This prospective randomized controlled trial included 60 patients with Kellgren-Lawrence Grade 3 or 4 osteoarthritis undergoing primary unilateral TKA at a tertiary care center. Patients were randomized into two groups: The TXA group (n = 30) received 1g intravenous TXA before tourniquet release, while the control group (n = 30) received normal saline. Outcome measures included intraoperative blood loss, post-operative drain output, hemoglobin changes, and transfusion requirements.

RESULTS

The TXA group demonstrated significantly lower intraoperative blood loss (205.33 vs. 305.67 mL, P < 0.001), total drain output (185.00 vs. 298.33 mL, P < 0.001), and proportional hemoglobin loss (14.19% vs. 19.98%, P < 0.001). Transfusion requirements were significantly reduced in the TXA group (6.67% vs. 26.67%, P = 0.039). No thromboembolic complications were observed in either group.

CONCLUSION

Intravenous TXA significantly reduces perioperative blood loss and transfusion requirements in TKA without increasing thromboembolic risk, supporting its routine use in blood conservation protocols.