Does tranexamic acid reduce blood loss and transfusion rates in unicompartmental knee arthroplasty?

Abstract

Tranexamic acid (TXA) has proven its efficacy in reducing blood loss and the need for blood transfusions in patients who have undergone a total knee arthroplasty (TKA) surgical procedure. However, no study has investigated the benefits of TXA in unicompartmental knee arthroplasty (UKA), especially, in regard to minimally invasive surgery (MIS) UKA. The purpose of this study is to attempt to prove the benefits of TXA and to identify the risks for blood loss and need for blood transfusions in MIS UKA. We prospectively followed 99 patients (120 knees) who had been treated with cemented MIS UKAs from January, 2011 to April, 2013 and who had had a minimum of 12 months of follow-up. The patients were divided into two groups; the TXA group (54 patients; 60 knees) and a control group (55 patients; 60 knees). The amount of blood loss collected in the drains was assessed 24-h postoperatively. The rates of peri-operative blood transfusions and hematocrit levels were recorded. We have also determined the factors affecting the peri-operative blood loss and these include gender, age, and body mass index (BMI). The patients in TXA group tend to have lower blood loss than had been seen in the control group, but the differences were not significant. The blood loss seen in the drains in the TXA group was 125 ± 43.6 ml (range 10-250 ml) versus 132 ± 71.4 ml (range 10-390 ml) in the control group (P = 0.49). No patients from either group required blood transfusions. There were not significant differences in blood loss among the different; genders, ages, or BMIs. Based on the study results, we suggest that the use of TXA for patients who undergo MIS UKA do not show benefits in the reduction of blood loss. There were no predictors for the risk of blood loss determined in MIS UKA.