Goyal N, Chen DB, Harris IA, Rowden N, Kirsh G, MacDessi SJ. Clinical and financial benefits of intra-articular tranexamic acid in total knee arthroplasty.
J Orthop Surg (Hong Kong) 2016;
24:3-6. [PMID:
27122503 DOI:
10.1177/230949901602400103]
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Abstract
PURPOSE
To determine whether intra-articular tranexamic acid (TXA) use after total knee arthroplasty (TKA) results in decreased postoperative blood transfusion and length of hospital stay.
METHODS
Medical records of 1981 patients (mean age, 69.2 years) who underwent primary TKA with (n=1006) or without (n=975) TXA use by any of 4 knee arthroplasty surgeons were reviewed. TXA (3000 mg/30ml) was administered via an epidural catheter into the knee joint after wound closure. Postoperative blood transfusion was given to patients with haemoglobin (Hb) level <80 g/dl on days 1 and 2 or with symptoms of acute anaemia.
RESULTS
Intra-articular TXA use after TKA resulted in a lower blood transfusion rate (4.5% [45/1006] vs. 14.8% [144/975], p<0.0001), fewer units of blood transfused (86 vs. 313 units, p<0.0001), fewer units of blood transfused per 100 patients (8.5 vs. 32.1, p<0.0001), and shorter length of hospital stay (4.7±2.3 vs. 5.3±2.7 days, p<0.0001). Total cost savings with respect to the reduction in blood transfusion was AU$143.68 per patient. When the change in length of hospital stay and TXA costs were included, the overall saving was AU$631.36 per patient.
CONCLUSION
Intra-articular TXA use can reduce costs as a result of decreased blood transfusion rate and length of hospital stay in patients undergoing TKA.
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