Can Low-dose Tranexamic Acid Decrease Blood Loss and Transfusion Requirements in Total Knee Arthroplasty?

Introduction Tranexamic acid (TA) has been used successfully in primary total knee arthroplasty (TKA) to minimize blood loss and transfusions. The aim of this study was to evaluate the effect of perioperative single low-dose TA administration on postoperative blood loss and necessity for blood transfusion in patients undergoing total knee arthroplasty under spinal anesthesia. Material and Methods Data of patients undergoing TKA between January 2013 through December 2015 were retrospectively reviewed. Patients that underwent unilateral knee arthroplasty under spinal anesthesia were separated into two groups: those where TA was used (10 mg/kg) and a control group where TA was not used. The following data were collected from medical records and compared between groups according to demographics, hemoglobin levels, and drainage amount. Results A total of 48 patients' data were evaluated (TA: 20; control: 28). The use of tranexamic acid in total knee arthroplasties seemed to reduce the postoperative drainage rate and blood transfusion requirement. Average 24-hour drainage levels were significantly lower in the TA group when compared to the control group. Required 24-hour total blood transfusion amounts were significantly higher in the control group. There was no difference in preoperative and postoperative sixth or 24th-hour hemoglobin levels between the groups. Conclusion A low or single dose of TA is a safe and effective agent that significantly lowers blood loss and allogeneic blood transfusion requirements.