Effects of topical administration of tranexamic acid on blood loss in total knee arthroplasty: A retrospective study (topical use of tranexamic acid in total knee arthroplasty)

Introduction: Total knee arthroplasty (TKA) is a complex surgical intervention. By 2030, TKA is expected to reach as much as 3.48 million interventions yearly. Perioperative bleeding is a major problem in TKA, with intraoperative blood loss from 300 to 2000 ml. In orthopedic surgery, tranexamic acid (TXA) has been used to prevent blood loss and enable faster recovery. Here we present the first experience of topically applied tranexamic acid for TKA in our hospital. Method: The effects of topical use of TXA on bleeding for the one-year period were retrospectively analyzed. Comparisons were made between two groups: the T-TK group in which TXA was topically applied, and the 0-TK group, in which the drug was not used. Demographic data, hemoglobin and hematocrit, transfusion of allogeneic blood products, intraoperative and postoperative blood loss, anticoagulant and antiplatelet therapy, and the occurrence of postoperative complications were analyzed. Results: The study included 104 patients, 35 in the T-TK group and 69 in the 0-TK group. It was shown that patients with significantly higher intraoperative bleeding received topical TXA. Patients in the T-TK group received fewer transfusions on the first, fourth, fifth, and sixth days. Conclusion: Analysis of the initial use of topical tranexamic acid in our hospital indicates that patients with more intraoperative bleeding were those to receive the treatment. There is a need for better-defined indications for the topical use of TXA, particularly as an alternative for patients who are at higher risk of developing thromboembolic complications.