Abstract:

Objective To compare the clinical efficacy of tranexamic acid by peri⁃articular injection vs. intra ⁃ articular perfusion for reducing postoperative bleeding during total knee arthroplasty. Methods A total of 140 patients with knee osteoarthritis who were admitted into our hospital from June 2018 to February 2020 for total knee arthroplasty were selected and randomly divided into observation group and control group in equal number， treated with peri⁃articular injection and intra⁃articular perfusion with tranexamic acid，respectively. The two groups were compared in terms of total postoperative blood loss，24⁃hour drainage volume and hidden blood loss at day 3 postoperatively，as well as NRS scores，circumference of thigh，superior patella and calf at days 5 and 10 post⁃ operatively. Results There were no significant differences in total blood loss and hidden blood loss at day 3 after operation between the groups. The 24⁃hour drainage volume of the observation group was significantly higher than that of the control group. There were no significant differences in the NRS score and lower limb swelling between the two groups at days 5 and 10 after operation. There was no significant difference in postoperative thrombotic complications between the two groups. Conclusion During total knee arthroplasty，peri ⁃ articular injection with tranexamic acid is as effective in reducing postoperative bleeding as intra⁃articular perfusion with the acid. However， it is still a good choice in consideration of the drainage tube⁃involved risks.

Key words:

tranexamic acid, total knee arthroplasty, peri?articular injection, intra?articular perfusion