AbstractBackground: Tranexamic acid (TXA) has been reported to reduce blood loss and be cost effective in many areas of orthopaedic surgery. TXA may be administered intra-venous (IV) or topically in the surgical wound or by intra-articular injection. There has been a growing attention of using TXA as intra-articular agent (IA-TXA) in total knee arthroplasty to avoid drug-induced venous thromboembolic (VTE) complication due to IV use of TXA. This study evaluates the efficacy of intra-articular and IV Tranexamic acid for reducing blood loss during Total Knee Arthroplasty (TKA) and objective is to evaluate post-operative total drain output. Materials and Methods: A prospective, clinical and comparative study was conducted in MGM Medical College and Hospital, Aurangabad, in 50 patients with osteoarthritis of knee joint and underwent TKR. Patients were divided in two groups, each receiving single dose of tranexamic acid either by intravenously (IV) or by intra-articular route. We evaluated post-operative total drain output. Results: Significant reduction in mean haemoglobin in both groups was seen post-operatively. Mean HTC was similar in both groups. Mean drain output was significantly lower on day 1 compared to day 0 in both the study groups. No change in BT, CT and PT/INR was observed in both groups. Significantly lower number of patients in group II required blood transfusion than group I patients. Conclusion: Intra-articular tranexamic acid application has better efficacy and is not only reduces blood loss but also decreases knee joint swelling after total knee Arthroplasty.

Keywords: Tranexamic acid, Total knee arthroplasty.