Comparison of intra articular versus intravenous tranexamic acid in reducing blood loss in total knee arthroplasty

Abstract

The average lifespan of human beings across the globe is increasing newlinedue to better, more accessible and advancements in medical treatment. The newlineage related disorders will also concomitantly rise with increasing age. With newlinerespect to orthopaedic speciality, the most common age related disorders are newlineosteoarthritis of the hip and knee. This results in significant loss of activity newlinedays and increased morbidity. Total knee arthroplasty has stood the test of newlinetime as the most satisfying surgical procedures for those with OA of the knee. newlineIt significantly improves the pain relief, range of motion and gives them pain newlinefree mobility. However, like any other surgical procedure TKA has a fair share newlineof risks and complications like blood loss, infection, implant loosening. Among newlinethese, blood loss in the post-operative period remains a significant risk with newlineincreased need for blood transfusions. The need for blood transfusion also newlineadds to the cost of expenditure. It also poses significant health risks such as newlinetransfusion related infections like malaria, HIV, Hepatitis B and C. Other less newlinecommon health risks are metabolic changes like electrolyte imbalances and newlinecoagulation risks such as disseminated intravascular coagulation (DIC). newlineThe need of the hour is a double blind, randomized control trial to newlineinvestigate whether the use of topical TXA in individuals undergoing TKA is newlinesafe and effective when compared to intravenous TXA. In addition to newlinecomparing efficacies between the two routes of administration, data newlinecomparing blood loss and the subsequent need for blood transfusion and also newlinethe associated complication rates have to be analysed as well. newlineIA route of TXA administration during TKA has newlineresulted a statistically significant drop in postoperative blood loss and newlinereduction in drop of Hb and PCV when compared to the IV group. The IA newlinegroup also had fewer blood transfusion requirements than the IV group newlinealthough it was not statistically significant due to relatively small sample size. newline