TOTAL KNEE ARTHROPLASTY?;

The treatment of choice for osteoarthritic knee is Total knee arthroplasty (TKA)and the most important problem in it is the blood loss. Objectives: To compare the postoperativemean blood loss with Tranexamic acid versus control after Total Knee Arthroplasty.Study Design: Randomized controlled trial. Setting: Ghurki Trust Teaching Hospital Lahore.Period: 01 year. Methodology: 100 patients were included and divided in 2 groups, selectedby non-probability purposive sampling, fulfilling inclusion and exclusion criteria. Group T(Tranexamic) received 15mg/kg IV Tranexamic acid 10 minutes before inflating tourniquet andthe same dose intravenously 3 hours post-operatively. Group C (control) received placebo(normal saline) intravenously. Blood loss collected in a container was measured with syringe/jarafter 24 hours of surgery. Results: In group C there were 23(46%) males and 27(54%) femaleswith male to female ratio 1:1.7 with mean age of 64yrs ± 6.3 yrs. In group T there were 28(56%)males and 22 (44%) females with male to female ratio 1.2:1 with mean age of 65yrs ± 7.4 yrs.After 24 hours Mean blood loss in Group C were 694 ±151 ml with 74 % patient in range of600-900ml while Mean blood loss in Group T were 388 ml ±105 ml with 76 % patient in rangeof 300-600ml. Mean decrease in blood loss with the use of tranexamic acid { mean blood lossin T group – mean blood loss in T group } were 306 ml which were statistically significant(p<0.05) using t Test. Conclusion: Tranexamic acid is a potent anti-fibrinolytic agent and its use intotal knee arthroplasty results in decrease in post-operative blood loss thereby decreasing theneed of blood transfusion.