Efficacy of aminocaproic, tranexamic acids in the control of bleeding during total knee replacement: a randomized clinical trial

Abstract

Antifibrinolytic agents produce a significant decrease in blood loss in patients undergoing total knee replacement, reflected in a reduction in the number of blood transfusions required.

Does Tranexamic Acid Save Blood in Minimally Invasive Total Knee Arthroplasty?

“…The sample size was calculated as follows. Camarasa et al reported the total blood loss after traditional total knee replacement in a control group was 1784 (660) mL [9]. Assuming a mean difference of 400 mL or greater total blood loss between two groups, to obtain a statistical power of 0.85 and alpha error of 0.05, 45 patients were required in each group.…”

Most Effective Regimen of Tranexamic Acid in Knee Arthroplasty: A Prospective Randomized Controlled Study in 240 Patients

“…It has been used successfully to reduce the blood loss in cardiac surgery [22], liver surgery [4], and gynecology [30]. The efficacy of tranexamic acid administered intravenously in preventing blood loss in TKA has been established in numerous studies [2,6,[12][13][14][15]29]. Topical application of tranexamic acid intraoperatively has shown a decrease in blood loss after TKA without the disadvantage of systemic absorption and thromboembolic complications [31].…”

“…A literature review shows studies where tranexamic acid was administered either as a single dose just before the release of the tourniquet [1,13] or along with an additional postoperative dose [2,6,12,14,32]. Inflation of the tourniquet stimulates the fibrinolytic system; administrating tranexamic acid before tourniquet inflation was studied by Tanaka et al [29] and Jansen et al [15].…”

Is Intraarticular Administration of Tranexamic Acid Better than Its Intravenous Administration in Reducing Blood loss after total Knee Arthroplasty?

“…Many studies and trials have now proved the efficacy and about safety of this drug. [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14] . Earlier an intravenous (IV)dose in various doses have been used by many surgeons and their results have been extensively studied.…”

“…Earlier an intravenous (IV)dose in various doses have been used by many surgeons and their results have been extensively studied. [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14] Oral TXA has shown to have equal efficacy by Zohar et al [1] Nowadays, there is a increase interest in usage of intraarticular administration [2] and many others [6], [7], [8] have shown good outcome for intraarticular administration of this drug in TKA. But all of them have compared intraarticular administration of TXA with placebo controls.…”