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J Knee Surg 2023; 36(06): 652-657
DOI: 10.1055/s-0041-1740585
Original Article

Different Doses of Intravenous Tranexamic Acid in Revision Total Knee Arthroplasty: A Retrospective Study

Liyile Chen   *
1   Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
,
Chenchen Zhao   *
1   Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
,
Yue Luo
1   Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
,
Qiuru Wang
1   Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
,
Qianhao Li
1   Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
,
Pengde Kang
1   Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
› Author Affiliations Funding This study was supported by the 1.3.5 Project of Sichuan University West China Hospital (grant no.: ZYJC18040).
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Abstract

Purpose This article assessed the efficacy and safety of different doses of intravenous tranexamic acid (TXA) in revision total knee arthroplasty (TKA).

Methods We retrospectively identified 122 patients in our institution who underwent revision TKA with a history of perioperative intravenous TXA utilization. According to the sum of intravenous TXA documented, all patients were divided into three groups: 1 g intravenous TXA, 2 g intravenous TXA, and equal or greater than 3 g intravenous TXA. The primary outcomes included total blood loss (TBL), hidden blood loss (HBL), transfusion rate, and the incidence of symptomatic venous thromboembolism among the three groups. A correlation analysis was conducted to analyze the correlation between the dose of TXA and the blood loss.

Results In total, there was no significance difference in TBL and revised HBL (rHBL) between the first two groups (1 g/dL for intravenous TXA, 2 g/dL for intravenous TXA; p = 0.486; p = 0.525). Equal or greater than 3 g intravenous TXA (≥3 g/dL for intravenous TXA) reached a significant reduction in TBL, rHBL, and length of stay compared with the first two groups (p = 0.01; p = 0.01; p = 0.01). The rate of transfusion between the three groups did not differ significantly (p = 0.21). Due to the limitations in sample size, only one symptomatic venous thromboembolism was reported in the 1 g intravenous TXA group.

Conclusion Applying the dose of intravenous TXA equal or greater than 3 g in revision TKA might further reduce the blood loss and shorten the length of stay.

Keywords

tranexamic acid - revision total knee arthroplasty - blood loss - transfusion.

Ethical Approval

This study protocol was approved by the Clinical Trials and Biomedical Ethics Committee of our institution and was registered in Chinese Clinical Trial Register (ChiCTR2100043117).


Authors' Contributions

P.K. and Y.L. contributed to the conception of the study. Q.W. and Q.L. performed the search and finished the data extraction. L.C. and C.Z. performed the data analyses and wrote the manuscript. P.K. helped perform the analysis with constructive discussions.


* Liyile Chen and Chenchen Zhao contributed equally to this work and should be regarded as first co-authors.




Publication History

Received: 26 April 2021

Accepted: 14 November 2021

Article published online:
24 December 2021

© 2021. Thieme. All rights reserved.

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