intra articular only compared with combined intra venous and intra articular tranexamic acid in total perioperative blood loss in primary unilateral total knee arthroplasty a retrospective study

only Compared with Combined Intra-venous and Intra-articular Tranexamic Acid in Total Perioperative Blood Loss in Primary Unilateral Total Knee Arthroplasty: A Retrospective Study. Abstract Background: Intravenous (IV), Intra-Articular (IA) Administration of Tranexamic Acid (TXA) and combined administration of IV and IA TXA for patients who received primary Total Knee Arthroplasty (TKA) have been reported in several literatures. However, IV TXA may cause unwanted side effects as increasing dose. Our study wants to compare the effect in total blood loss of IA TXA only and combined therapy with IA and IV TXA in patients undergoing primary total knee arthroplasty. Methods: The retrospective study included all patients received primary unilateral TKA from May 2014 to June 2016 at Kaohsiung Veterans General Hospital. There were 782 knees included. These knees were divided into three groups: IA TXA only, combined IA and IV TXA, and without TXA using. All patients were operated under spinal or general anesthesia using tourniquet and cemented posterior stabilized type implant. Estimated postoperative blood loss was calculated as OSTHEO Formula. Results: In these 782 knees on the study, there were 566 women (72.38%) and 216 men (27.62%). Mean age was 69.93±8.25 years of age. There was no significant difference over gender and age between these three groups. The group of IA-only showed significant reduced total blood loss compared with the group of combined IA IV TXA (P=0.016) and the group of none of TXA using(P=0.000). Conclusions: Intraoperative intra-articular TXA is an effective and convenient method to reduce total blood loss in the patient undergoing primary TKA and even with better efficacy than perioperative combined therapy of IV and IA TXA in our study.