| Summary: | The number of total knee arthroplasties (TKA) performed is
around two million annually worldwide and this number is
expected to increase fivefold by 2025. The most common
indication is osteoarthritis of the knee. Blood loss is
significant during the post-operative period and blood
transfusion when necessary has its own drawbacks. The use
of intravenous tranexamic acid has significantly reduced
blood loss. We analysed 35 patients who underwent staged
bilateral TKA between August 2013 and February 2016 and
had administered intra-articular tranexamic acid for one knee
and intravenous tranexamic acid for the other knee. The
results were analysed based on post-operative blood loss,
change in haemoglobin (Hb) level and haematocrit (PCV)
and the need for blood transfusion. The average postoperative
blood loss was 129.57 ml and 277.71 ml for intra
articular group and intravenous group respectively. A control
group (no drug or placebo group) with age matched patients
(n= 21) was chosen from medical records. The average blood
loss in the control group was 493.81 ml. The fall in Hb level
and PCV was 0.72 gm/dl and 2.62 % (Intra-articular Group),
1.36 gm/dl and 4.34 % (Intravenous Group) and 2.62 gm/dl
and 5.52 % (Control). The number of transfusions were two
(Intra-articular Group), five (Intravenous Group) and nine
(Control). We conclude that when compared with
intravenous route, intra-articular administration has
significantly reduced blood loss, Hb level and PCV fall and
the rate of blood transfusion.
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