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The role of tranexamic acid in reducing blood loss in total knee replacement
Authors:Virender Kumar Gautam  Balaji Sambandam  Shailendra Singh  Prince Gupta  Rajat Gupta  Lalit Maini
Institution:1. Consultant Orthopedic Surgeon, 187/1, Mathi Apartments, S. V. Lingam Salai, K.K. Nagar, Chennai 600078, India;2. Consultant Orthopedic Surgeon, S 29, G block, TNHB Apartments, Luz Church Road, Mylapore, Chennai 600004, India;1. Associate Professor, Dept. of Orthopaedics, NIMS Medical College, Shobha Nagar, Jaipur, Rajasthan, India;2. Professor, Dept. of Orthopaedics, NIMS Medical College, Shobha Nagar, Jaipur, Rajasthan, India;1. Consultant Ortho, Sant Parmanand Hospital, 18, Sham Nath Marg, Civil Lines, Delhi 110054, India;2. Senior Consultant Ortho, Sant Parmanand Hospital, 18, Sham Nath Marg, Civil Lines, Delhi 110054, India;3. Head of Department Ortho, Sant Parmanand Hospital, 18, Sham Nath Marg, Civil Lines, Delhi 110054, India;4. Clinical Fellow Ortho, Sant Parmanand Hospital, 18, Sham Nath Marg, Civil Lines, Delhi 110054, India;5. Trainee Ortho, Sant Parmanand Hospital, 18, Sham Nath Marg, Civil Lines, Delhi 110054, India;6. Consultant Radiology, Sant Parmanand Hospital, 18, Sham Nath Marg, Civil Lines, Delhi 110054, India;1. Assistant Professor, Department of Orthopedics, BRD Medical College, Gorakhpur, UP 273001, India;2. Associate Professor, Department of Orthopedics, BRD Medical College, Gorakhpur, UP 273001, India;1. Specialist and Assistant Professor, Department of Orthopaedics, Postgraduate Institute of Medical Education and Research & Associated Dr. Ram Manohar Lohia Hospital, New Delhi, India;2. Assistant Professor, Orthopaedics, UP Rural Institute of Medical Sciences & Research, Saifai, Etawah, India;3. Professor and Head of Department, Department of Orthopaedics, Postgraduate Institute of Medical Education and Research & Associated Dr. Ram Manohar Lohia Hospital, New Delhi, India
Abstract:BackgroundTotal knee arthroplasty is associated with significant perioperative blood loss which may necessitate blood transfusion. In this prospective randomised case control study we analysed the efficacy and safety of tranexamic acid in reducing perioperative blood loss and requirement of blood transfusion in total knee arthroplasty.MethodsFourteen patients (group A) undergoing total knee replacement were given intravenous tranexamic acid twice, once ten minutes before tourniquet deflation and once after four hours. Thirteen patients (group B) were observed as a separate group without the administration of the drug. Total perioperative blood loss, need of blood transfusion and D-dimer assay were analysed subsequently.ResultsThe average blood loss in the first group was 266.2 ml and in the second group was 667.5 ml (p < 0.001). average requirement of transfusion in both the groups were 0.54 and 1.6 units of blood respectively (p < 0.001). There was no case of deep vein thrombosis or any other untoward effects.ConclusionHence from these evidences it was concluded that administration of tranexamic acid during total knee replacement helps to reduce blood loss without increasing the risk of deep vein thrombosis.
Keywords:Total knee replacement  Tranexamic acid  Blood loss
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