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Intravenous Use of Tranexamic Acid in Total Knee Arthroplasty with no Tourniquet* * Work developed at the Department of Orthopedics and Traumatology, Hospital Policlínica Pato Branco, Pato Branco, Paraná, Brazil.

Abstract

Objective:

To identify blood transfusion requirements and postoperative complications in patients undergoing total knee arthroplasty (TKA) with no tourniquet and intraoperative intravenous administration of tranexamic acid.

Methods:

This retrospective observational study analyzed 49 preopeative and postoperative medical records of patients undergoing TKA. A paired t-test compared changes in hemoglobin (HB) and packed cell volume (PCV), and an independent t-test with Welch correction compared HB and PCV changes between genders. A Spearman correlation test determined associations between age and days of postoperative hospitalization with HB and PCV changes. The significance level adopted was p < 0.05.

Results:

The patients' mean age was 71.9 ± 6.7 years; most subjects were women (73.5%). The right side (59.2%) was the most affected. Only one participant required a blood transfusion, while three subjects had complications during the postoperative follow-up. No patient had a thromboembolic event. The median length of postoperative hospital stay was 2 days (interquartile range [IQR] = 1.0). There were reductions in HB and PCV levels between the pre-operative and postoperative period, and female patients had a higher HB reduction.

Conclusion:

TKA with tranexamic acid and no tourniquet did not cause significant postoperative complications or require blood transfusions.

Keywords
tranexamic acid; arthroplasty, replacement, knee; tourniquet

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