Tranexamic acid is widely used to reduce blood loss after total knee arthroplasty (TKA) in patients with osteoarthritis, but its safety and efficacy in patients with rheumatoid arthritis is unclear. Researchers retrospectively assessed intravenous tranexamic acid after simultaneous bilateral TKA in patients with rheumatoid arthritis.
In the study, published in BMC Musculoskeletal Disorders, the investigators concluded that tranexamic acid effectively reduced blood loss, decreased transfusion risk, and reduced ambulation and hospitalization duration after simultaneous bilateral TKA in patients with rheumatoid arthritis.
Tranexamic Acid Effective in Rheumatoid Arthritis
A total of 74 patients with rheumatoid arthritis who underwent TKA were assigned to either 15 mg/kg of intravenous tranexamic acid before incision (n=50) or a control group without tranexamic acid (n=24).
The primary end points were total blood loss and intraoperative blood loss, and other secondary outcomes included hemoglobin and hematocrit drop on day 3 post-TKA, transfusions, hospitalization expenses, and complication rate.
According to the report, patients in the tranexamic acid group had significantly lower mean total blood loss, intraoperative blood loss, and transfusion volume compared with the control group.
Additionally, hemoglobin and hematocrit drop on day 3 was also lower in the tranexamic acid group (P<.05). Researchers found similar differences for transfusion rate, ambulation time, and length of stay; although complication rate and hospitalization expenses were not significantly different between the groups.
Ultimately, the authors suggested that “[tranexamic acid] could effectively decrease blood loss, reduce transfusion risk, shorten ambulation time and length of stay following SBTKA in patients with RA, without increasing the risk of complications.”
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