[Research progress on tranexamic acid application strategy in total knee arthroplasty]

Area of Science:

• Orthopedic Surgery
• Pharmacology
• Hemorrhage Control

Background:

• Total knee arthroplasty (TKA) frequently involves significant postoperative blood loss.
• Managing blood loss and transfusion rates is crucial for TKA patient outcomes.
• Tranexamic acid (TXA) is an antifibrinolytic agent with potential to mitigate TKA-related bleeding.

Purpose of the Study:

• To review current strategies for using tranexamic acid (TXA) in total knee arthroplasty (TKA).
• To evaluate different methods of TXA administration and dosing for TKA.
• To determine optimal TXA protocols for reducing blood loss without increasing thrombotic complications.

Main Methods:

• Literature review of studies investigating TXA in TKA.
• Analysis of varying TXA dosages (e.g., weight-based, fixed doses like 1.5g or 3.0g).
• Comparison of different administration routes (intravenous, topical, oral) and timing (preoperative, intraoperative, postoperative).

Main Results:

• TXA has demonstrated efficacy in reducing blood loss, hemoglobin drop, and transfusion rates in TKA patients.
• Optimal TXA protocols regarding dose, route, and timing are still under investigation.
• Current evidence suggests TXA can be used safely without a significant increase in thrombosis risk.

Conclusions:

• Establishing a gold standard for TXA application in TKA is needed.
• Further research should focus on refining TXA protocols for maximum efficacy and safety.
• Scientific guidelines are essential for optimizing TXA's utility in TKA to minimize blood loss and transfusion requirements.