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Tranexamic acid in the management of blood-loss in TKA

Kalin Mihov, Svetoslav Dobrilov, Maksim Zagorov, Todor Gerov, Aleksandar Gospodinov, Gergana Nenova


Total knee replacement is one of most common orthopedic procedure, which is associated with significant blood-loss. Administration of tranexamic acid is one of the methods to decrease the perioperative bleeding and haemotransfusion necessity. In the Dept. of Orthopedics and Traumatology since 2013 have been made 383 TKA. In 250 patients were administrated 500 mg i.v. 10 min prior to first incision and 500 mg i.v. at tourniquet release. Topical use of TXA were used in 58 cases. Patients were administrated  with 1,5 g TXA in 100cc NaCl for 3 min. before deflation. Peri and postoperative blood-loss, hemoglobin level decrease and transfusion requirements were observed. Results showed about  45 % lower bleeding than the control group compared to i.v use and about 15% less bleeding compared to the topical application group. All the patients from control group required blood transfusion after surgery due to blood loss -  about 890 ml on average. Topical application group shows average blood-loss 560 ml. , and i.v. group about 460 ml blood-loss.None of the patients with i. v. application of TXA required blood transfusion. Blood loss in the groups administering TXA i.v. or topical is significantly lowerwith better results in i.v. aplication. Administration of TXA is safe and reliable method for reducing bleeding associated with TKA which decreases necessity of haemotransfusion.



TKA, tranexamic acid, blood loss,tourniquet

Full Text


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About The Authors

Kalin Mihov
Medical University of Varna

Department of Ortopedics and Traumatology, Universiy Hospital `St. Marina`, Faculty of Medicine

Svetoslav Dobrilov


Department of Ortopedics and Traumatology, Universiy Hospital `St. Marina`, Faculty of Medicine

Maksim Zagorov


Department of Ortopedics and Traumatology, Universiy Hospital `St. Marina`, Faculty of Medicine

Todor Gerov


Department of Ortopedics and Traumatology, Universiy Hospital `St. Marina`, Faculty of Medicine

Aleksandar Gospodinov


Department of Ortopedics and Traumatology, Universiy Hospital `St. Marina`, Faculty of Medicine

Gergana Nenova


Department of Ortopedics and Traumatology, Universiy Hospital `St. Marina`, Faculty of Medicine

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