Topical and intravenous tranexamic acid in reducing blood loss in total knee arthroplasty? A comparative study in Indian population

Objective: - To compare the amount of blood loss during total knee arthroplasty with use of Topical and IV tranexamic acid in different groups.

Material and Methods: This is a prospective, longitudinal single cohort study undertaken in the department of orthopaedics, Sir Ganga Ram Hospital, New Delhi from March 2012 to March 2015 including 3 Groups with 100 patients in each group. Group I with 2gm of Intra-articular infusion of tranexamic acid through the drain site, Group II is 1.5 gm of intravenous injection starting pre-operatively and second dose of 1.5 gm during post-operative period 6 hours later. Group III includes patients acting as control group with no tranexamic acid injection.

Results: The Average blood loss in the 3 Groups viz Group I, II and III after 48 hrs were 400 ± 104.42, 436.33±109.67 and 832±159.97 respectively and p values were 0.912, 0.012 and 0.009 For I & II, I & III and II & III respectively. Almost similar amount of blood loss was there in IV and Topical group which was not statistically significant. Intra-articular and Intravenous Group of people show similar drop of haemoglobin and drain collection during post-operative Period at 2^nd, 4^th, 6^th and 48 hrs and POD5 (post-operative day 5). The haemoglobin drop After POD 5 in group I, II and III were 1.89±0.1, 2.2±0.34, 3.97±0.23 and p values were 0.698, 0.019 and 0.018 for Group I & II, I & III and II & III respectively.