• Kazunari Ishida, Nobuhiro Tsumura, Atsushi Kitagawa, Sayaka Hamamura, Koji Fukuda, Yoshihiro Dogaki, Seiji Kubo, Tomoyuki Matsumoto, Takehiko Matsushita, Takaaki Chin, Tetsuhiro Iguchi, Masahiro Kurosaka, and Ryosuke Kuroda.
• Department of Orthopaedic Surgery, Hyogo Rehabilitation Centre Central Hospital, 1070 Akebono-cho, Nishi-ku, Kobe, 651-2181, Japan. wavedreamer17@yahoo.co.jp
• Int Orthop. 2011 Nov 1;35(11):1639-45.

PurposeThis is a randomised controlled trial to examine whether intra-articular injection of tranexamic acid (TXA) decreases blood loss, as well as reducing leg swelling after total knee arthroplasty (TKA).MethodsWe performed 100 TKA in osteoarthritis patients. At closure, a total of 2,000 mg/20 ml TXA was injected into the knee joint through a closed suction drain (TXA group). For the control group, the same volume of physiological saline was injected. The pre-operative condition of the patients, post-operative haemoglobin (Hb) levels, discharge volumes from drain, D-dimer and needs for transfusion were compared between these two groups. Furthermore, leg diameters (thigh, suprapatellar portion and calf girth) were measured pre- and post-operatively to investigate whether TXA has an influence on leg swelling after surgery.ResultsThe results revealed that post-operative decrease in Hb level was significantly reduced in the TXA group. Furthermore, knee joint swelling after operation was significantly suppressed in the TXA group compared to the control group.ConclusionsThe results revealed intra-articular administration of TXA decreased not only blood loss, but also knee joint swelling after TKA.

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