The use of tranexamic acid could reduce acute blood loss significantly without any adverse effect resulted from drug interaction with concomitant use of indirect factor Xa inhibitor following TKA. Therefore, simple combination of these drugs can be recommended to reduce post-operative blood loss as well as to reduce DVT following TKA.
There remains low incidence of VTE following TKA in East Asians even without chemoprophylaxis. Although short-term fondaparinux protocol could reduce the incidence of overall DVT, its routine use seems debatable due to extremely rare proximal DVT and symptomatic PE and drug-related bleeding complication. However, modified and selective use of chemoprophylaxis would be considerable in high risk patients.
Minimally invasive TKA has benefit in quadriceps recovery at earlier rehabilitation period although catch-up recovery in conventional TKA was accelerated from the postoperative 6 weeks to 3 months. It may support the concept of early return to full activity after minimally invasive TKA, and patients might get back early to normal life.
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