Study on the Effects of Tranexamic Acid on Perioperative Inflammation, Long-Term Functional Recovery, and Satisfaction in Total Knee Arthroplasty: A Follow-up Study.

PURPOSE: To explore the anti-inflammatory effects and safety of Tranexamic Acid (TXA) during the perioperative period of Total Knee Arthroplasty (TKA) in patients with Knee Osteoarthritis (KOA), and to follow-up on long-term knee joint function and patient satisfaction.

METHODS

A prospective non-randomized controlled cohort study evaluated TXA efficacy in 130 unilateral TKA patients with KOA between January 2019 and March 2021. Patients were randomized into TXA (n=65) and control (n=65) groups. The TXA group received both intravenous and intra-articular TXA as required Postoperative coagulation profiles, day-3 systemic inflammatory markers, 6-month DVT/complication rates, and 2-year functional outcomes (knee function, QoL [Quality of Life], satisfaction) were assessed.

RESULTS

No significant differences in demographics, clinical data, or KOA severity were observed between the control and TXA groups (P>0.05). Only TXA group showed decreased post-operative Fibrinogen (FIB) levels, while Erythrocyte Sedimentation Rate (ESR)(decreased to 15.41 ±4.39 mm/h), C-reactive Protein (CRP) (decreased to 33.32 ±11.56 mg/L), and Interleukin 6 (IL-6) levels significantly decreased (decreased to 111.38 ±30.14 μg/mL) on the third day post-operation (P<0.001). During the 6 months, specific complications did not significantly differ, but the overall complication rate notably decreased in the TXA group (OR=0.23, 95% CI 0.08 to 0.61, P = 0.012). At 2-year follow-up, TXA group showed significantly better joint function and QoL (P<0.05). Postoperative satisfaction correlated with preoperative TXA use, neutrophil count, NLR, ESR, and CRP. Multivariate analysis identified TXA as an independent predictor of satisfaction (P<0.05). TXA group exhibited reduced inflammation, lower complication rates, and improved long-term outcomes, demonstrating favorable perioperative and long-term outcomes in KOA management.

CONCLUSION

TXA has a significant effect on perioperative inflammation, long-term functional recovery and satisfaction in TKA.