Comparison of Local and Systemic Effects of Tranexamic Acid and Transcollation® in Total Knee Arthroplasty

Background: Use of tranexamic acid (TXA) is a pharmacological intervention to achieve hemostasis during total knee arthroplasty (TKA). Transcollation® using Aquamantys® (radiofrequency bipolar hemostatic sealing device) is a physiological hemostatic sealing method to achieve hemostasis during TKA. The local and systemic postoperative effects of these two interventions were never compared in the total knee arthroplasty literature. Methods: This is a retrospective cohort study. Two groups of patients who underwent unilateral TKAs were identified: the TXA group and the Aquamantys® group. There were 96 patients in the TXA group and 95 patients in the Aquamantys® group. The proportion of cases in the TXA group and Aquamantys® group that developed each individual clinically significant local and systemic effect postoperatively was calculated and the odds ratio of such an outcome among these two groups was analyzed. Results: There was a clinically meaningful trend towards decreased odds of developing superficial surgical site infection requiring antibiotic therapy in the TXA group compared to Aquamantys® group. We also found that on postoperative day 1, the odds of developing fever >101°F is low in TXA group compared to Aquamantys® group. Conclusions: This study provides preliminary clinical evidence that is suggestive of beneficiary effect of TXA on wound healing after TKA, specifically, the prevention of superficial surgical site infection. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.