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Updated: Jul 12, 2026
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Efficacy of tranexamic acid with/without drain in knee arthroplasty: a randomized prospective clinical study from
Mhmoud Adnan Al Salamah1,2, Khaled Alomar3, Kamar Shaker4
1Orthopedic Surgery and Joint Surgery, Idlib University Hospital, Idlib, Syria.
Purpose:
This study evaluated the outcomes of intra-articular tranexamic acid (TXA) and/or suction drainage in patients undergoing total knee arthroplasty (TKA).
Materials And Methods:
Following approval from the institutional review board, a prospective, randomized, and blinded clinical study was conducted in Northwest Syria, including 192 patients who underwent unilateral TKA between August 2023 and April 2025. Patients were randomly assigned to three groups: TXA with suction drainage, TXA only, or suction drainage only. Patients with coagulopathies, active infections, previous knee surgeries, or contraindications to TXA were excluded. All procedures followed a standardized surgical and postoperative protocol. Outcome measures included total and hidden blood loss (HBL), drainage volume, transfusion rate, limb swelling, and wound complications.
Results:
Total blood loss was lowest in Group 2 (710 mL) compared to Group 1 (891 mL) and Group 3 (1391 mL) (P < 0.0001). No transfusions were required in Group 2, whereas 7.8% of Group 1 and 36% of Group 3 received transfusions (P < 0.0001). No wound complications occurred in Group 2. HBL and early swelling were higher in Group 2 but resolved within 6 weeks. Knee range of motion at 2 months showed no significant differences among groups (p = 0.0789).
Conclusion:
Intra-articular TXA without suction drainage appears to be the safest and most effective method to reduce perioperative blood loss in TKA. Larger multicenter studies are recommended.