Comparing efficacy of three methods of tranexamic acid administration in reducing hemoglobin drop following total knee arthroplasty

J Arthroplasty. 2014 Aug;29(8):1521-4. doi: 10.1016/j.arth.2014.02.031. Epub 2014 Mar 6.


The ideal method of providing tranexamic acid (TXA) for decreasing hemoglobin drop after TKA is still controversial. In this clinical trial, 200 patients were randomly allocated to four groups. In group 1,500 mg TXA was administered intravenously. In group 2, the joint irrigated with 3 g of TXA in 100 cc of saline. In group 3, 1.5 g of TXA was injected through the drain. Group 4 did not take TXA. Albeit all methods had a statistical effect on hemoglobin drop, drainage and number of transfused units when compared to controls, but intravenous injection of TXA seems to be much more effective in terms of reducing hemoglobin drop and transfused units; and what's more TXA injection by drain is more effective regarding to reducing postoperative drainage.

Keywords: hemoglobin drop; intra-articular injection; intravenous injection; total knee arthroplasty; tranexamic acid.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Antifibrinolytic Agents / administration & dosage*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Blood Loss, Surgical / prevention & control*
  • Blood Transfusion
  • Drainage / methods
  • Female
  • Hemoglobins / metabolism*
  • Humans
  • Injections, Intra-Articular
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Sodium Chloride / administration & dosage
  • Tranexamic Acid / administration & dosage*
  • Treatment Outcome


  • Antifibrinolytic Agents
  • Hemoglobins
  • Sodium Chloride
  • Tranexamic Acid