Does tranexamic acid save blood in minimally invasive total knee arthroplasty?

BACKGROUND: Tranexamic acid (TEA) reportedly reduces perioperative blood loss in TKA. However, whether it does so in minimally invasive TKA is not clear. QUESTIONS/PURPOSES: We asked whether TEA would reduce blood loss and blood transfusion requirements after minimally invasive TKA. PATIENTS AND METHODS: We prospectively enrolled 100 patients who underwent minimally invasive TKAs: 50 received one intravenous injection of TEA before deflation of the tourniquet and a control group of 50 patients received an equivalent volume of placebo. We compared changes in hemoglobin, postoperative drainage, total blood loss, and transfusion rates between the two groups. RESULTS: The total blood loss was less for patients in the TEA group than for the control group: 833 mL (374-1014 mL) versus 1453 mL (733-2537 mL), respectively. The rate of blood transfusion also was less for patients in the TEA group than in the control group (4% versus 20%). The hemoglobin levels on the second and fourth postoperative days were greater for patients in the TEA group than in the control group. CONCLUSIONS: Our data suggest one intraoperative injection of TEA decreased the total blood loss and need for transfusion after minimally invasive TKA. LEVEL OF EVIDENCE: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.