I s local infiltration of Tra nexamic Acid efficacious in reducing blood loss after simultaneous bilateral total knee Arthroplasty? A prospective randomized study
BackgroundTotal knee arthroplasty (TKA) is one of the most successful and effective surgical strategy to enhance the quality of life in patients with end-stage arthritis of knee. Significant bloodlossoccuringinTKAduetobonecuts,resultsinwoundhaematoma,postoperativepain, seroma formation and arthrofibrosis thus leading to impaired final outcome. TKA performed bilaterally under single anaesthesia results in substantial perioperative blood loss. Many strategies, including the use of Platelet rich plasma (PRP) and Tranexamic acid (TXA), have been employed to minimise perioperative blood loss and the resultant demand of allogenic bloodtransfusion[1-3].SomeresearchershavereportedthebeneficialeffectsofTXAinTKA when used in an injectable form [4]. But issue of the safety of intravenous (IV) TXA has been raised by arthroplasty surgeons due to the risk of deep vein thrombosis (DVT) or pulmonary thromboembolisminhigh-riskpatients.Eventhoughfewstudieshavehighlightedtheefficacy of local Tranexamic Acid [2, 5, 6], it is still not very well accepted route of administration amongst theclinicians.
Aditya K Aggarwal
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