Tranexamic Acid in Total Knee Replacement Reduces Wound Complication and Transfusion Rates; An Observational Study

Background and Aims Tranexamic Acid (TXA) has been shown to reduce transfusion rates in Total Knee Replacement (TKR) without complication. We undertook a cohort study investigating TXA use with TKR, wound complication and transfusion rate. We add ed intravenous TXA to our standardised TKR protocol for 6 months of a 12 - month study period, with no other changes during this time. Methods All patients undergoing primary TKR over the 12 - month study period were identified. Notes and online records were r eviewed to collate details including demographics, wound complication, blood transfusion, length of stay, and haemoglobin levels. All study patients received a Columbus navigated TKR, and routine thromboembolic and antibiotic prophylaxis. Results 124 patie nts were included, 72 receiving TXA. A significant change in wound complication was noted; 15% of patients (n=11) of the TXA group had a wound complication, with 40% of patients (n=21) in the control group (p = 0.003). All four patients requiring a blood t ransfusion were in the control group (p = 0.029). There was no diagnosed pulmonary embolusor mortality. Conclusion In our unit we have demonstrated a significantly lower transfusion rate, wound complication rate and length of stay, without any significant increase in thromboembolic disease with the use of TXA in TKR.