The Role of Tranexamic Acid in Reducing Blood Loss Following Total Joint Arthroplasty: A Review Article
-
Ehsan Fallah
,
Alireza Moharrami
,
Amir Hossein Ahmadi Nouri
,
Mir Mansour Moazen Jamshidi
,
Amir Reza Mafi
,
SM Javad Mortazavi
Abstract
Total Joint Arthroplasty (TJA) is a major surgery performed for patients who suffer from severe joint destruction. It is so important to reduce the blood loss in the TJA surgery to decrease the infection rate, falling, and other complications following the surgery. Many methods could reduce blood loss, such as mechanical methods and chemical methods. Tranexamic acid (TXA) is a chemical method to reduce blood loss in surgery. There are numerous methods of administration of TXA in the literature, such as intravenous (IV), intra-articular, and a combination of intra-articular and -venous methods. In the present review article, we review the studies that compared the efficacy of each method of the TXA administration.
1. McCalden RW, Hart GP, MacDonald SJ, Naudie DD, Howard JH, Bourne RB. Clinical results and survivorship of the GENESIS II
total knee arthroplasty at a minimum of 15 years.
J Arthroplasty. 2017;32(7):2161-6. doi: 10.1016/j.arth.2017.02.006.
[PubMed: 28285899].
2. Maradit KH, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA, et al. Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am. 2015;97(17):1386-97. doi: 10.2106/JBJS.N.01141. [PubMed: 26333733]. [PubMed Central: PMC4551172].
3. Singh JA, Yu S, Chen L, Cleveland JD. Rates of total joint replacement in the United States: Future projections to 2020-2040 using the national inpatient sample. J Rheumatol. 2019;46(9): 1134-40. doi: 10.3899/jrheum.170990. [PubMed: 30988126].
4. Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br. 2004;86(4):561-5. [PubMed: 15174554].
5. Drain NP, Gobao VC, Bertolini DM, Smith C, Shah NB, Rothenberger SD, et al. Administration of tranexamic acid improves long-term outcomes in total knee arthroplasty. J Arthroplasty. 2020;35(6S):S201-S206. doi: 10.1016/j.arth.2020.02.047. [PubMed: 32209286]. [PubMed Central: PMC7239733].
6. Poeran J, Rasul R, Suzuki S, Danninger T, Mazumdar M, Opperer M, et al. Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: Retrospective analysis of effectiveness and safety. BMJ. 2014;349:g4829. doi: 10.1136/bmj.g4829. [PubMed: 25116268]. [PubMed Central: PMC4130961].
7. Fillingham YA, Ramkumar DB, Jevsevar DS, Yates AJ, Bini SA, Clarke HD, et al. Tranexamic acid in total joint arthroplasty: The endorsed clinical practice guides of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. Reg Anesth Pain Med. 2019;44(1):7-11. doi: 10.1136/rapm-2018-000024. [PubMed: 30640647].
8. Zhang YM, Yang B, Sun XD, Zhang Z. Combined intravenous and intra-articular tranexamic acid administration in total knee arthroplasty for preventing blood loss and hyperfibrinolysis: A randomized controlled trial. Medicine (Baltimore). 2019;98(7):e14458. doi: 10.1097/MD.0000000000014458. [PubMed: 30762760]. [PubMed Central: PMC6408055].
9. Karampinas P, Vlamis J, Bakalakos M, Papadelis E, Lampropoulou-Adamidou K, Spyridon P. The combined intrarticular/intravenous administration of tranexamic acid in cemented total knee arthroplasty. Acta Orthopaedica Et Traumatologica Hellenica. 2018;69(2):22-8.
10. Lee SY, Chong S, Balasubramanian D, Na YG, Kim TK. What is the ideal route of administration of tranexamic acid in TKA? A randomized controlled trial. Clin Orthop Relat Res. 2017;475(8):1987-96. doi: 10.1007/s11999-017-5311-z. [PubMed: 28283902]. [PubMed Central: PMC5498377].
11. Oztas S, Ozturk A, Akalin Y, Sahin N, Ozkan Y, Otuzbir A, et al. The effect of local and systemic application of tranexamic acid on the amount of blood loss and allogeneic blood transfusion after total knee replacement. Acta Orthop Belg. 2015;81(4):698-707. Retrieved from. [PubMed: 26790793].
12. George J, Eachempati KK, Subramanyam KN, Gurava Reddy AV. The comparative efficacy and safety of topical and intravenous tranexamic acid for reducing perioperative blood loss in Total knee arthroplasty- A randomized controlled non-inferiority trial. Knee. 2018;25(1):185-91. doi: 10.1016/j.knee.2017.11.006. [PubMed: 29343449].
13. Deng Z, Sheng P, Xu D, Fu M, He A, Liao W, et al. Comparison of hemostatic effect and safety in primary unilateral total hip arthroplasty receiving different anticoagulants after anti-fibrinolysis with tranexamic acid. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020;34(12):1561-7. [In Chinese]. doi: 10.7507/1002-1892.202006007. [PubMed: 33319536]. [PubMed Central: PMC8171553].
14. Abdel MP, Chalmers BP, Taunton MJ, Pagnano MW, Trousdale RT, Sierra RJ, et al. Intravenous versus topical tranexamic acid in total knee arthroplasty: Both effective in a randomized clinical trial of 640 patients. J Bone Joint Surg Am. 2018;100(12):1023-9. doi: 10.2106/JBJS.17.00908. [PubMed: 29916929].
15. Aggarwal AK, Singh N, Sudesh P. Topical vs intravenous tranexamic acid in reducing blood loss after bilateral total knee arthroplasty: A prospective study. J Arthroplasty. 2016;31(7): 1442-8. doi: 10.1016/j.arth.2015.12.033. [PubMed: 26947543].
16. Aguilera X, Martinez-Zapata MJ, Hinarejos P, Jordan M, Leal J, Gonzalez JC, et al. Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: A multicenter, randomized, controlled trial. Arch Orthop Trauma Surg. 2015;135(7):1017-25. doi: 10.1007/s00402-015-2232-8. [PubMed: 25944156].
17. Ahmed S, Ahmed A, Ahmad S, Javed S, Aziz A. Blood loss after intraarticular and intravenous tranexamic acid in total knee arthroplasty. J Pak Med Assoc. 2018;68(10):1434-7. [PubMed: 30317337].
18. Chen JY, Chin PL, Moo IH, Pang HN, Tay DK, Chia SL, et al. Intravenous versus intra-articular tranexamic acid in total knee arthroplasty: A double-blinded randomised controlled
noninferiority trial. Knee. 2016;23(1):152-6. doi: 10.1016/j.knee.2015.09.004. [PubMed: 26746044].
19. Chen Y, Chen Z, Cui S, Li Z, Yuan Z. Topical versus systemic tranexamic acid after total knee and hip arthroplasty: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2016;95(41):e4656.doi:10.1097/MD.0000000000004656. [PubMed: 27741100]. [PubMed Central: PMC5072927].
20. Digas G, Koutsogiannis I, Meletiadis G, Antonopoulou E, Karamoulas V, Bikos C. Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty. Eur J Orthop Surg Traumatol. 2015;25(7):1181-8. doi: 10.1007/s00590-015-1664-8. [PubMed: 26169991].
21. Drosos GI, Ververidis A, Valkanis C, Tripsianis G, Stavroulakis E, Vogiatzaki T, et al. A randomized comparative study of topical versus intravenous tranexamic acid administration in enhanced recovery after surgery (ERAS) total knee replacement. J Orthop. 2016;13(3):127-31. doi: 10.1016/j.jor.2016.03.007. [PubMed: 27222617]. [PubMed Central: PMC4821446].
22. Gomez-Barrena E, Ortega-Andreu M, Padilla-Eguiluz NG, Perez-Chrzanowska H, Figueredo-Zalve R. Topical intra-articular compared with intravenous tranexamic acid to reduce blood loss in primary total knee replacement: A double-blind, randomized, controlled, noninferiority clinical trial. J Bone Joint Surg Am. 2014;96(23):1937-44. doi: 10.2106/JBJS.N.00060. [PubMed: 25471907].
23. Goyal N, Chen DB, Harris IA, Rowden NJ, Kirsh G, MacDessi SJ. Intravenous vs intra-articular tranexamic acid in total knee arthroplasty: a randomized, double-blind trial. J Arthroplasty. 2017;32(1):28-32. doi: 10.1016/j.arth.2016.07.004. [PubMed: 27567057].
24. Jules-Elysee KM, Tseng A, Sculco TP, Baaklini LR, McLawhorn AS, Pickard AJ, et al. Comparison of topical and intravenous tranexamic acid for total knee replacement: A randomized double-blinded controlled study of effects on tranexamic acid levels and thrombogenic and inflammatory marker levels. J Bone Joint Surg Am. 2019;101(23):2120-8. doi: 10.2106/JBJS.19.00258. [PubMed: 31800425]. [PubMed Central: PMC7406146].
25. Keyhani S, Esmailiejah AA, Abbasian MR, Safdari F. Which route of tranexamic acid administration is more effective to reduce blood loss following total knee arthroplasty? Arch Bone Jt Surg. 2016;4(1):65-9. [PubMed: 26894222]. [PubMed Central: PMC4733239].
26. Laoruengthana A, Rattanaprichavej P, Rasamimongkol S, Galassi M, Weerakul S, Pongpirul K. Intra-articular tranexamic acid mitigates blood loss and morphine use after total knee arthroplasty. A randomized controlled trial. J Arthroplasty. 2019;34(5):877-81. doi: 10.1016/j.arth.2019.01.030. [PubMed: 30755381].
27. May JH, Rieser GR, Williams CG, Markert RJ, Bauman RD, Lawless MW. The assessment of blood loss during total knee arthroplasty when comparing intravenous vs intracapsular administration of tranexamic acid. J Arthroplasty. 2016;31(11):2452-7. doi: 10.1016/j.arth.2016.04.018. [PubMed: 27259391].
28. Mortazavi SJ, Sattartabar B, Moharrami A, Kalantar SH. Intra-articular versus intravenous tranexamic acid in total knee arthroplasty: A randomized clinical trial. Arch Bone Jt Surg. 2020;8(3):355-62. doi: 10.22038/abjs.2019.39080.2039. [PubMed: 32766392]. [PubMed Central: PMC7358233].
29. Bagheri N, Amini M, Pourahmad A, Vosughi F, Moharrami A, Mortazavi S. Comparison of combined intraarticular (IA) and intravenous (IV) administration of tranexamic acid with IA and IV alone in patients undergoing total knee arthroplasty without drainage catheter: A clinical trial study. Research Square. 2021. [Preprint].
30. Patel JN, Spanyer JM, Smith LS, Huang J, Yakkanti MR, Malkani AL. Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty: A prospective randomized study. J Arthroplasty. 2014;29(8):1528-31. doi: 10.1016/j.arth.2014.03.011. [PubMed: 24768543].
31. Prakash J, Seon JK, Park YJ, Jin C, Song EK. A randomized control trial to evaluate the effectiveness of intravenous, intra-articular and topical wash regimes of tranexamic acid in primary total knee arthroplasty. J Orthop Surg (Hong Kong). 2017;25(1):2309499017693529. doi: 10.1177/2309499017693529. [PubMed: 28222649].
32. Sarzaeem MM, Razi M, Kazemian G, Moghaddam ME, Rasi AM, Karimi M. Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty. J Arthroplasty. 2014;29(8):1521-4. doi:
10.1016/j.arth.2014.02.031. [PubMed: 24726174].
33. Seo JG, Moon YW, Park SH, Kim SM, Ko KR. The comparative efficacies of intra-articular and IV tranexamic acid for reducing blood loss during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2013;21(8):1869-74. doi: 10.1007/s00167-012-2079-2. [PubMed: 22729012].
34. Song EK, Seon JK, Prakash J, Seol YJ, Park YJ, Jin C. Combined administration of IV and topical tranexamic acid is not superior to either individually in primary navigated TKA. J Arthroplasty. 2017;32(1):37-42. doi: 10.1016/j.arth.2016.06.052. [PubMed: 27633946].
35. Soni A, Saini R, Gulati A, Paul R, Bhatty S, Rajoli SR. Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty. J Arthroplasty. 2014;29(8):1525-7. doi: 10.1016/j.arth.2014.03.039. [PubMed: 24814890].
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total knee arthroplasty at a minimum of 15 years.
J Arthroplasty. 2017;32(7):2161-6. doi: 10.1016/j.arth.2017.02.006.
[PubMed: 28285899].
2. Maradit KH, Larson DR, Crowson CS, Kremers WK, Washington RE, Steiner CA, et al. Prevalence of total hip and knee replacement in the United States. J Bone Joint Surg Am. 2015;97(17):1386-97. doi: 10.2106/JBJS.N.01141. [PubMed: 26333733]. [PubMed Central: PMC4551172].
3. Singh JA, Yu S, Chen L, Cleveland JD. Rates of total joint replacement in the United States: Future projections to 2020-2040 using the national inpatient sample. J Rheumatol. 2019;46(9): 1134-40. doi: 10.3899/jrheum.170990. [PubMed: 30988126].
4. Sehat KR, Evans RL, Newman JH. Hidden blood loss following hip and knee arthroplasty. Correct management of blood loss should take hidden loss into account. J Bone Joint Surg Br. 2004;86(4):561-5. [PubMed: 15174554].
5. Drain NP, Gobao VC, Bertolini DM, Smith C, Shah NB, Rothenberger SD, et al. Administration of tranexamic acid improves long-term outcomes in total knee arthroplasty. J Arthroplasty. 2020;35(6S):S201-S206. doi: 10.1016/j.arth.2020.02.047. [PubMed: 32209286]. [PubMed Central: PMC7239733].
6. Poeran J, Rasul R, Suzuki S, Danninger T, Mazumdar M, Opperer M, et al. Tranexamic acid use and postoperative outcomes in patients undergoing total hip or knee arthroplasty in the United States: Retrospective analysis of effectiveness and safety. BMJ. 2014;349:g4829. doi: 10.1136/bmj.g4829. [PubMed: 25116268]. [PubMed Central: PMC4130961].
7. Fillingham YA, Ramkumar DB, Jevsevar DS, Yates AJ, Bini SA, Clarke HD, et al. Tranexamic acid in total joint arthroplasty: The endorsed clinical practice guides of the American Association of Hip and Knee Surgeons, American Society of Regional Anesthesia and Pain Medicine, American Academy of Orthopaedic Surgeons, Hip Society, and Knee Society. Reg Anesth Pain Med. 2019;44(1):7-11. doi: 10.1136/rapm-2018-000024. [PubMed: 30640647].
8. Zhang YM, Yang B, Sun XD, Zhang Z. Combined intravenous and intra-articular tranexamic acid administration in total knee arthroplasty for preventing blood loss and hyperfibrinolysis: A randomized controlled trial. Medicine (Baltimore). 2019;98(7):e14458. doi: 10.1097/MD.0000000000014458. [PubMed: 30762760]. [PubMed Central: PMC6408055].
9. Karampinas P, Vlamis J, Bakalakos M, Papadelis E, Lampropoulou-Adamidou K, Spyridon P. The combined intrarticular/intravenous administration of tranexamic acid in cemented total knee arthroplasty. Acta Orthopaedica Et Traumatologica Hellenica. 2018;69(2):22-8.
10. Lee SY, Chong S, Balasubramanian D, Na YG, Kim TK. What is the ideal route of administration of tranexamic acid in TKA? A randomized controlled trial. Clin Orthop Relat Res. 2017;475(8):1987-96. doi: 10.1007/s11999-017-5311-z. [PubMed: 28283902]. [PubMed Central: PMC5498377].
11. Oztas S, Ozturk A, Akalin Y, Sahin N, Ozkan Y, Otuzbir A, et al. The effect of local and systemic application of tranexamic acid on the amount of blood loss and allogeneic blood transfusion after total knee replacement. Acta Orthop Belg. 2015;81(4):698-707. Retrieved from. [PubMed: 26790793].
12. George J, Eachempati KK, Subramanyam KN, Gurava Reddy AV. The comparative efficacy and safety of topical and intravenous tranexamic acid for reducing perioperative blood loss in Total knee arthroplasty- A randomized controlled non-inferiority trial. Knee. 2018;25(1):185-91. doi: 10.1016/j.knee.2017.11.006. [PubMed: 29343449].
13. Deng Z, Sheng P, Xu D, Fu M, He A, Liao W, et al. Comparison of hemostatic effect and safety in primary unilateral total hip arthroplasty receiving different anticoagulants after anti-fibrinolysis with tranexamic acid. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2020;34(12):1561-7. [In Chinese]. doi: 10.7507/1002-1892.202006007. [PubMed: 33319536]. [PubMed Central: PMC8171553].
14. Abdel MP, Chalmers BP, Taunton MJ, Pagnano MW, Trousdale RT, Sierra RJ, et al. Intravenous versus topical tranexamic acid in total knee arthroplasty: Both effective in a randomized clinical trial of 640 patients. J Bone Joint Surg Am. 2018;100(12):1023-9. doi: 10.2106/JBJS.17.00908. [PubMed: 29916929].
15. Aggarwal AK, Singh N, Sudesh P. Topical vs intravenous tranexamic acid in reducing blood loss after bilateral total knee arthroplasty: A prospective study. J Arthroplasty. 2016;31(7): 1442-8. doi: 10.1016/j.arth.2015.12.033. [PubMed: 26947543].
16. Aguilera X, Martinez-Zapata MJ, Hinarejos P, Jordan M, Leal J, Gonzalez JC, et al. Topical and intravenous tranexamic acid reduce blood loss compared to routine hemostasis in total knee arthroplasty: A multicenter, randomized, controlled trial. Arch Orthop Trauma Surg. 2015;135(7):1017-25. doi: 10.1007/s00402-015-2232-8. [PubMed: 25944156].
17. Ahmed S, Ahmed A, Ahmad S, Javed S, Aziz A. Blood loss after intraarticular and intravenous tranexamic acid in total knee arthroplasty. J Pak Med Assoc. 2018;68(10):1434-7. [PubMed: 30317337].
18. Chen JY, Chin PL, Moo IH, Pang HN, Tay DK, Chia SL, et al. Intravenous versus intra-articular tranexamic acid in total knee arthroplasty: A double-blinded randomised controlled
noninferiority trial. Knee. 2016;23(1):152-6. doi: 10.1016/j.knee.2015.09.004. [PubMed: 26746044].
19. Chen Y, Chen Z, Cui S, Li Z, Yuan Z. Topical versus systemic tranexamic acid after total knee and hip arthroplasty: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2016;95(41):e4656.doi:10.1097/MD.0000000000004656. [PubMed: 27741100]. [PubMed Central: PMC5072927].
20. Digas G, Koutsogiannis I, Meletiadis G, Antonopoulou E, Karamoulas V, Bikos C. Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty. Eur J Orthop Surg Traumatol. 2015;25(7):1181-8. doi: 10.1007/s00590-015-1664-8. [PubMed: 26169991].
21. Drosos GI, Ververidis A, Valkanis C, Tripsianis G, Stavroulakis E, Vogiatzaki T, et al. A randomized comparative study of topical versus intravenous tranexamic acid administration in enhanced recovery after surgery (ERAS) total knee replacement. J Orthop. 2016;13(3):127-31. doi: 10.1016/j.jor.2016.03.007. [PubMed: 27222617]. [PubMed Central: PMC4821446].
22. Gomez-Barrena E, Ortega-Andreu M, Padilla-Eguiluz NG, Perez-Chrzanowska H, Figueredo-Zalve R. Topical intra-articular compared with intravenous tranexamic acid to reduce blood loss in primary total knee replacement: A double-blind, randomized, controlled, noninferiority clinical trial. J Bone Joint Surg Am. 2014;96(23):1937-44. doi: 10.2106/JBJS.N.00060. [PubMed: 25471907].
23. Goyal N, Chen DB, Harris IA, Rowden NJ, Kirsh G, MacDessi SJ. Intravenous vs intra-articular tranexamic acid in total knee arthroplasty: a randomized, double-blind trial. J Arthroplasty. 2017;32(1):28-32. doi: 10.1016/j.arth.2016.07.004. [PubMed: 27567057].
24. Jules-Elysee KM, Tseng A, Sculco TP, Baaklini LR, McLawhorn AS, Pickard AJ, et al. Comparison of topical and intravenous tranexamic acid for total knee replacement: A randomized double-blinded controlled study of effects on tranexamic acid levels and thrombogenic and inflammatory marker levels. J Bone Joint Surg Am. 2019;101(23):2120-8. doi: 10.2106/JBJS.19.00258. [PubMed: 31800425]. [PubMed Central: PMC7406146].
25. Keyhani S, Esmailiejah AA, Abbasian MR, Safdari F. Which route of tranexamic acid administration is more effective to reduce blood loss following total knee arthroplasty? Arch Bone Jt Surg. 2016;4(1):65-9. [PubMed: 26894222]. [PubMed Central: PMC4733239].
26. Laoruengthana A, Rattanaprichavej P, Rasamimongkol S, Galassi M, Weerakul S, Pongpirul K. Intra-articular tranexamic acid mitigates blood loss and morphine use after total knee arthroplasty. A randomized controlled trial. J Arthroplasty. 2019;34(5):877-81. doi: 10.1016/j.arth.2019.01.030. [PubMed: 30755381].
27. May JH, Rieser GR, Williams CG, Markert RJ, Bauman RD, Lawless MW. The assessment of blood loss during total knee arthroplasty when comparing intravenous vs intracapsular administration of tranexamic acid. J Arthroplasty. 2016;31(11):2452-7. doi: 10.1016/j.arth.2016.04.018. [PubMed: 27259391].
28. Mortazavi SJ, Sattartabar B, Moharrami A, Kalantar SH. Intra-articular versus intravenous tranexamic acid in total knee arthroplasty: A randomized clinical trial. Arch Bone Jt Surg. 2020;8(3):355-62. doi: 10.22038/abjs.2019.39080.2039. [PubMed: 32766392]. [PubMed Central: PMC7358233].
29. Bagheri N, Amini M, Pourahmad A, Vosughi F, Moharrami A, Mortazavi S. Comparison of combined intraarticular (IA) and intravenous (IV) administration of tranexamic acid with IA and IV alone in patients undergoing total knee arthroplasty without drainage catheter: A clinical trial study. Research Square. 2021. [Preprint].
30. Patel JN, Spanyer JM, Smith LS, Huang J, Yakkanti MR, Malkani AL. Comparison of intravenous versus topical tranexamic acid in total knee arthroplasty: A prospective randomized study. J Arthroplasty. 2014;29(8):1528-31. doi: 10.1016/j.arth.2014.03.011. [PubMed: 24768543].
31. Prakash J, Seon JK, Park YJ, Jin C, Song EK. A randomized control trial to evaluate the effectiveness of intravenous, intra-articular and topical wash regimes of tranexamic acid in primary total knee arthroplasty. J Orthop Surg (Hong Kong). 2017;25(1):2309499017693529. doi: 10.1177/2309499017693529. [PubMed: 28222649].
32. Sarzaeem MM, Razi M, Kazemian G, Moghaddam ME, Rasi AM, Karimi M. Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty. J Arthroplasty. 2014;29(8):1521-4. doi:
10.1016/j.arth.2014.02.031. [PubMed: 24726174].
33. Seo JG, Moon YW, Park SH, Kim SM, Ko KR. The comparative efficacies of intra-articular and IV tranexamic acid for reducing blood loss during total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2013;21(8):1869-74. doi: 10.1007/s00167-012-2079-2. [PubMed: 22729012].
34. Song EK, Seon JK, Prakash J, Seol YJ, Park YJ, Jin C. Combined administration of IV and topical tranexamic acid is not superior to either individually in primary navigated TKA. J Arthroplasty. 2017;32(1):37-42. doi: 10.1016/j.arth.2016.06.052. [PubMed: 27633946].
35. Soni A, Saini R, Gulati A, Paul R, Bhatty S, Rajoli SR. Comparison between intravenous and intra-articular regimens of tranexamic acid in reducing blood loss during total knee arthroplasty. J Arthroplasty. 2014;29(8):1525-7. doi: 10.1016/j.arth.2014.03.039. [PubMed: 24814890].
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| Files | ||
| Issue | Vol 8, No 1 (2022) | |
| Section | Review Article | |
| DOI | https://doi.org/10.18502/jost.v8i1.9038 | |
| Keywords | ||
| Tranexamic Acid; Postoperative Hemorrhage; Arthroplasty; Knee; Hip | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Fallah E, Moharrami A, Ahmadi Nouri AH, Moazen Jamshidi MM, Mafi AR, Mortazavi SJ. The Role of Tranexamic Acid in Reducing Blood Loss Following Total Joint Arthroplasty: A Review Article. J Orthop Spine Trauma. 2022;8(1):5-8.
