PURPOSE: To compare the outcome after simultaneous bilateral total knee arthroplasty (TKA) with or without an intra-articular tranexamic acid (TXA) wash in terms of blood loss, haemoglobin change, and transfusion requirement. METHODS: 35 women and 10 men (mean age, 67.5 years) who underwent primary simultaneous bilateral TKA by a single senior surgeon were compared with 45 matched controls. In the TXA group, 1500 mg of TXA diluted in 100 ml of 0.9% sodium chloride was administered as a wash after cementing of implant and before closure of the retinaculum. At least 5 minutes of contact time was allowed before wound closure and tourniquet deflation. No drain was used. RESULTS: No patients had thromboembolic complication. Compared with controls, the TXA group had lower perioperative blood loss (920 vs. 657 ml, p=0.001), total blood loss (997 vs. 679 ml, p<0.001), blood transfusion rate (60% vs. 37.8%, p=0.035), percentage of patients requiring more than one blood unit (24.4% vs. 8.9%, p=0.048), and length of hospitalisation (6 vs. 4 days, p<0.001). Nonetheless, the 2 groups were comparable in blood units and volume transfused. CONCLUSION: An intra-articular TXA wash during simultaneous bilateral TXA reduced total blood loss and resulted in a difference of 22.2% in blood transfusion rate and a 2-day reduction in the length of hospital stay.
PURPOSE: To compare the outcome after simultaneous bilateral total knee arthroplasty (TKA) with or without an intra-articulartranexamic acid (TXA) wash in terms of blood loss, haemoglobin change, and transfusion requirement. METHODS: 35 women and 10 men (mean age, 67.5 years) who underwent primary simultaneous bilateral TKA by a single senior surgeon were compared with 45 matched controls. In the TXA group, 1500 mg of TXA diluted in 100 ml of 0.9% sodium chloride was administered as a wash after cementing of implant and before closure of the retinaculum. At least 5 minutes of contact time was allowed before wound closure and tourniquet deflation. No drain was used. RESULTS: No patients had thromboembolic complication. Compared with controls, the TXA group had lower perioperative blood loss (920 vs. 657 ml, p=0.001), total blood loss (997 vs. 679 ml, p<0.001), blood transfusion rate (60% vs. 37.8%, p=0.035), percentage of patients requiring more than one blood unit (24.4% vs. 8.9%, p=0.048), and length of hospitalisation (6 vs. 4 days, p<0.001). Nonetheless, the 2 groups were comparable in blood units and volume transfused. CONCLUSION: An intra-articularTXA wash during simultaneous bilateral TXA reduced total blood loss and resulted in a difference of 22.2% in blood transfusion rate and a 2-day reduction in the length of hospital stay.
Authors: Jared Ze Yang Yeh; Jerry Yongqiang Chen; Hamid Rahmatullah Bin Abd Razak; Bryan Huai Gu Loh; Ying Hao; Andy Khye Soon Yew; Shi-Lu Chia; Ngai Nung Lo; Seng Jin Yeo Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-05-28 Impact factor: 4.342
Authors: Jeffrey M Wilde; Steven N Copp; Kace A Ezzet; Adam S Rosen; Richard H Walker; Julie C McCauley; Audree S Evans; William D Bugbee Journal: Clin Orthop Relat Res Date: 2022-04-01 Impact factor: 4.176
Authors: Vasileios Soranoglou; Lazaros A Poultsides; Georgios K Triantafyllopoulos; Ivan De Martino; Stavros G Memtsoudis; Thomas P Sculco Journal: HSS J Date: 2017-12-07