Tranexamic acid given intraoperatively reduces blood loss after total knee replacement: a randomized, controlled study

Acta Anaesthesiol Scand. 2002 Nov;46(10):1206-11. doi: 10.1034/j.1399-6576.2002.461007.x.


Background: Extensive blood loss in total knee replacement (TKR) surgery is well known and is associated with a high transfusion rate of allogenic blood. Tranexamic acid (TXA) has been shown to reduce blood loss by 50% in this patient group, but only in cases with a perioperative loss of 1400-1800 ml. This study was performed to see if TXA offers any advantages in knee replacement surgery with blood loss at 800 ml.

Methods: Thirty consecutive patients scheduled for TKR in spinal anesthesia with the use of a tourniquet, were randomized to TXA or non-TXA. Tranexamic acid 10 mg kg-1 was given at conclusion of surgery and again 3 h later. Blood loss was registered.

Results: Total blood loss was at all times significantly lower in the TXA group compared to the non-TXA group (409.7+/-174.9 ml vs. 761.7+/-313.1 ml; P<0.001). There were no differences in coagulation parameters. No patients in the TXA group had a blood transfusion vs. 13% in the non-TXA group (NS). No complications were registered in the two groups.

Conclusion: We conclude that TXA significantly reduces blood loss after total knee replacement surgery.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antifibrinolytic Agents / therapeutic use*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Blood Loss, Surgical / prevention & control*
  • Blood Volume / drug effects
  • Female
  • Hemostasis, Endoscopic*
  • Humans
  • Intraoperative Care / statistics & numerical data*
  • Male
  • Time Factors
  • Tranexamic Acid / therapeutic use*


  • Antifibrinolytic Agents
  • Tranexamic Acid