@article{article_1225644, title={Do We Concern Ourselves with Blood Loss and Blood Transfusions of the Peri-articular Injection of Tranexamic Acid after Unilateral Total Knee Arthroplasty?}, journal={Abant Medical Journal}, volume={11}, pages={184–193}, year={2022}, author={Çataltepe, Aziz and Öznam, Kadir}, keywords={Total Diz Artroplastisi, Traneksamik Asit, Periartiküler Enjeksiyon, Kan Kaybı, Total Knee Arthroplasty, Tranexamic Acid, Peri-Articular Injection, Blood Loss}, abstract={Objective: The means of peri-articular (PA) administration of tranexamic acid (TXA) is not examined sufficiently in unilateral total knee arthroplasty (TKA). The primary purpose of this study was to evaluate postoperative blood loss and transfusions rates after the administration of PA injection of TXA in TKA. In addition, PA TXA may decrease pain owing to reduced hemarthrosis after TKA. Materials and Methods: In this retrospective study, 113 patients who underwent a primary unilateral TKA with or without a PA injection of TXA were included. A total of 1500 mg/50 ml TXA was injected into the extra-articular soft tissue around the medial, lateral capsules and muscular soft tissue around the quadriceps tendon immediately after cementation the prothesis, but before capsular closure and 15 minutes before the deflation of the tourniquet. A total of 56 patients in the control group did not receive TXA. The surgical procedure was standardized in all of the patients. Results: There was a statistically significant reduction in hidden blood loss, estimated blood loss, and receiving a postoperative allogeneic blood transfusion in the TXA group compared with the control group (p=0.0001). We found a significant correlation between blood transfusion and the length of hospital stay (p=0.0001). No significant difference was found regarding pain VAS score after postoperative 1st day and postoperative 3rd day (p=0.597 and p=0.183, respectively). 1500 mg/50 ml (30 mg/ml) TXA was a relatively optimal dose to minimize the cytotoxic effects on the soft tissue around the knee compared with 50 mg/ml. No patients encountered any thromboembolic and wound complications. Conclusion: The PA administration of TXA may offer a significant reduction in postoperative blood loss and transfusions rates as well as the length of hospital stay without increasing the risk of thromboembolic complications and cytotoxic effects on cartilage and peri-articular soft tissue. However, we did not observe a significant reduction in postoperative pain VAS score.}, number={3}, publisher={Bolu Abant Izzet Baysal University}