Topical Versus Intravenous Tranexamic Acid in Total Knee Arthroplasty

Intravenous administration of tranexamic acid (TA) is common in orthopedic surgery. The ideal dose and administration route of the drug in total knee arthroplasty (TKA) is under investigation.

The objective of this randomized clinical trial was to verify differences between topical and intravenous administration of TA in TKA regarding blood loss and coagulation variables.

Patients undergoing TKA were randomized to receive TA intravenously (20 mg in 100 ml of saline), topically (1.5 g in 50 ml of saline, sprayed over the operated site, before closure) or intravenous saline (100 ml). Suction drains were maintained for 48 hours, in order to measure blood loss. Data analysis is being undertaken now, in order to compare the two routes of administration of the drug.

Inclusion criteria

Patients in need of unilateral total knee arthroplasty (TKA) due to arthrosis, Albach grades III and IV were eligible

Exclusion criteria

• history or identified risk for deep vein thrombosis or pulmonary embolism
• history of coagulation or cardiovascular disorders
• vascular diseases
• pregnancy
• current use of anticoagulation drugs
• previous orthopedic surgery in the legs.