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Topical Administration of Tranexamic Acid Plus Diluted-Epinephrine in Primary Total Knee Arthroplasty: A Randomized
Fuqiang Gao1, Wei Sun1, Wanshou Guo1
1Osteonecrosis and Joint-Preserving and Reconstruction Center, Beijing, China; Department of Orthopedic Surgery, Beijing, China; Beijing Key Laboratory of Arthritic and Rheumatic Diseases, Beijing, China; China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.
Abstract:
The aim of this trial was to evaluate the efficacy and safety of intra-articular administration of tranexamic acid (TXA) plus diluted-epinephrine (DEP) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty (TKA) without drainage. One hundred patients scheduled to undergo TKA were randomized into two groups: 50 patients received intra-articular 3g TXA plus 0.25mg DEP (1:200,000), and 50 patients received 3g topical TXA alone. The results showed that topical combined administration significantly reduced total blood loss (P=0.006), hidden blood loss (P=0.000) and transfusion rate (0% vs. 4%), without increasing the risk of thromboembolic and hemodynamic complications (P>0.05). Therefore, topical TXA plus DEP was effective and safe in reducing blood loss and transfusion following TKA, without substantial complications.
