Use of Tranexamic Acid in the Total Knee Arthroplasty.

Tranexamic acid (TXA) is used to control both intraoperative (IO) and postoperative (PO) bleeding during various surgical procedures. Moreover, TXA was found to indirectly reduce post-surgery infection rates and decrease hemorrhage-related mortality in trauma patients. This study aims to determine how safe and effective tranexamic acid treatment is for patients undergoing primary total knee arthroplasty. The study is a prospective, randomized, triple-blinded, placebo-controlled study. Ninety participants were enrolled between July 2021 and September 2022 and followed up with every patient for six months.

The study was done in Damascus, Syria. Participants were randomly assigned following simple randomization procedures (computerized random numbers) to 1 of 2 groups. The allocation was put into concealed envelopes independent of the surgeon and the author, and the randomization was performed by a research fellow who was not involved in patient care. Participants who went unilateral primary TKA and did not use TXA, just IV normal saline (0.9% sodium chloride), formed the control group. In contrast, the intervention group comprised participants who went primary unilateral TKA and used two-dose intravenous tranexamic acid that was applied as follows: 10mg/kg of Tranexamic Acid in 100 Milliliters（ml) normal saline (0.9% sodium chloride), the first dose 15 minutes before the tourniquet deflation and the second dose at 180 minutes after the first dosage.

Inclusion criteria

• Patients with primary knee osteoarthrosis who underwent unilateral primary TKA

Exclusion criteria

• Known allergic reaction to tranexamic acid
• Secondary arthritis (ex., Rheumatic arthritis, traumatic arthritis, septic arthritis)
• BMI less than 20 and more than 40.
• Patients having vascular or hematologic disease.
• Patients who were taking anti-coagulant medicine and couldn't stop it.
• Patients having acute or chronic renal failure.
• Patients classified as the AAA as grade four or five.
• Patients with intra-operative complications such as intra-operative fractures or vascular injuries.
• Post-traumatic and secondary knee arthritis patients.
• Revisions and complex primary cases.
• Patients with an active infection or a history of lower limp infection.