Tranexamic Acid Decreases Incidence of Blood Transfusion in Simultaneous Bilateral Total Knee Arthroplasty

J Arthroplasty. 2015 Dec;30(12):2106-9. doi: 10.1016/j.arth.2015.06.040. Epub 2015 Jun 22.


Blood management for simultaneous bilateral total knee arthroplasty (TKA) patients is more challenging than in unilateral arthroplasty. We examined if administration of tranexamic acid (TXA) to patients undergoing simultaneous bilateral TKA would reduce blood loss and decrease allogeneic blood transfusion requirements. A retrospective review of 103 patients, 57 in the control and 46 in the TXA group, was performed. There was higher postoperative day 1 hemoglobin in patients receiving TXA (2.95±1.33 versus 4.33±1.19, P<0.0001). There was also a decrease in the transfusion incidence with administration of TXA (17.4% versus 57.9%, P<0.0001). In conclusion, we have shown that TXA is an effective tool in reducing the transfusion rates by almost 70% in simultaneous bilateral total knee arthroplasty.

Keywords: anemia; blood loss; simultaneous bilateral; total knee arthroplasty; tranexamic acid; transfusion.

MeSH terms

  • Aged
  • Antifibrinolytic Agents / therapeutic use*
  • Arthroplasty, Replacement, Knee / adverse effects*
  • Blood Loss, Surgical / prevention & control*
  • Blood Transfusion / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Period
  • Retrospective Studies
  • Tranexamic Acid / therapeutic use*
  • Transfusion Reaction


  • Antifibrinolytic Agents
  • Tranexamic Acid