Blood-saving strategies in total primary knee replacement

The objective of this study was to make an update on the different strategies in the blood saving in prosthetic primary knee surgery, through a bibliographical review; As well as to know what strategies are followed in different hospitals in our field, through a survey. We carried out a descriptive transversal observational study based on a survey of 64 surgeons and a bibliographical research on the different aspects included in the survey. Surgeons refer that they have presurgical blood-saving protocols implanted in their Hospital at 48.4%. The use of tranexamic acid (ATX) is quite widespread 71.9% of respondents (46/64). It is administered intravenously prior to surgery in 26.6% of cases, intraarticularly by 21.9% and in a combination of both in 23.4%. The preferred time for the placement of ischemia by surgeons is 57.8% prior to painting the field, while a 39.1% prefer to place it in sterile conditions. 3.1% of surgeons claim to implant the prosthesis without using ischemia in surgery. The use of ATX as the primary blood-saving strategy in TKR is being imposed. There is No consensus as to the optimal dose or its route of administration. The efficacy of the ATX is influencing the elimination of post-surgical drainage and the implementation of early rehabilitation programs.