A comparison of the effects on postoperative bleeding of the intra-articular application of tranexamic acid and adrenalin in total knee arthroplasty.

Objective: To compare the efficacies of intra-articular applications of tranexamic acid and adrenaline on postoperative bleeding after total knee arthroplasty.

Methods: The single-center, retrospective, controlled study was conducted at Selcuk University , department of orthopedic surgery and comprised data of patients who underwent primary, unilateral, cemented total knee arthroplasty between July 2012 and December 2014. Group 1 had received tranexamic acid 1g after closure of articular capsule. Group 2 had received adrenalin. Group 3, the control group, received no medication intraarticularly after total knee arthroplasty. The amount of blood collected in the drain and postoperative alterations in haemoglobin and haematocrit values were compared.

Results: Of the total 90 subjects, there were 30(33.33%) in each of the three groups. The decrease of haemoglobin and haematocrit values in Group 1 was statistically significant compared to both Group 2 and Group 3 (p<0.05). The amount of blood collected in the drains was remarkably lower in Groups I and 2 compared to Group III (p<0.05). No deep venous thrombosis or pulmonary emboli were encountered across the sample.

Conclusions: Intra-articular administration of tranexamic acid was found to be beneficial and safe for the achievement of effective haemostasis after total knee arthroplasty.