J Knee Surg 2017; 30(05): 474-478
DOI: 10.1055/s-0036-1593371
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Topical Tranexamic Acid in Total Knee Arthroplasty Patients with Increased Thromboembolic Risk

Jonathon Spanyer
1  Adult Reconstruction Program, University of Louisville, Louisville, Kentucky
,
Jay Patel
1  Adult Reconstruction Program, University of Louisville, Louisville, Kentucky
,
Eric Emberton
1  Adult Reconstruction Program, University of Louisville, Louisville, Kentucky
,
Langan S. Smith
2  KOH Medical Group, KentuckyOne Health, Louisville, Kentucky
,
Arthur L. Malkani
1  Adult Reconstruction Program, University of Louisville, Louisville, Kentucky
› Author Affiliations
Further Information

Publication History

21 July 2016

07 August 2016

Publication Date:
05 October 2016 (online)

Abstract

The purpose of this study was to evaluate the efficacy and safety profiles of topical tranexamic acid (TXA) in patients undergoing elective total knee arthroplasty (TKA) with comorbid conditions precluding them from intravenous (IV) TXA use. A total of 104 patients were divided into two groups: 47 in the normal-risk group and 57 in the high-risk group, with the latter representing those with one or more risk factors for venous thromboembolism (VTE). Demographics were similar between groups, and there were no differences with regard to postoperative changes in hemoglobin (− 3.42 g/dL ± 1.07 and − 3.68 g/dL ± 1.07, p = 0.214), total drain output (630.2 mL ± 331.6 and 566.9 mL ± 343.9, p = 0.344), postoperative transfusion rate (2.1 and 3.5%, p = 0.675), or total number of complications 3 (6.5%) and 5 (8.8%) for the normal- and high-risk groups, respectively (p = 0.671). Topical TXA exhibited a similar safety and efficacy profile in reducing postoperative blood loss in a group of patients at increased thromboembolic risk, without a significant increase in complications or thromboembolic events. Topical TXA appears to represent a safe and efficacious alternative to IV TXA in patients at high risk for VTE undergoing TKA.