Single dose Intravenous Tranexamic acid may not be adequate to reduce blood loss and blood transfusion requirement in patients undergoing single stage bilateral total knee arthroplasty

Simultaneous bilateral total knee arthroplasty (TKA) causes increased blood loss and increases the risk of venous thromboembolism. Tranexamic acid (TXA) is commonly used to minimize blood loss and transfusion requirements. However, the optimal regimen of TXA in single stage bilateral TKA is still not defined. In this retrospective study, 35 patients who received TXA and 31 patients who did not receive TXA were evaluated for blood loss and transfusion requirement. Both the groups were comparable in terms of age, sex, body mass index and preoperative haemoglobin (Hb) and haematocrit (Hct). There was no significant difference in the change in Hb levels (2.42 +/- 1.28 vs 2.44 +/- 1.31; p=0.95) and Hct (1.37 +/- 0.96 vs 1.62 +/- 0.98, p=0.22) between the groups. There were no significant differences between the study and control groups in the intraoperative blood loss (163.71 vs 165.32 ml, p=0.92), drain output (621.71 vs 695.65 ml, p=0.65) and total blood loss (785.0 vs 860.97, p=0.40). There was no significant difference in allogeneic blood transfusion between the groups (62.85% received blood in the study group vs 58.06% in the control group, p>0.05). Single intraoperative dose of TXA may not be adequate to reduce blood loss and blood transfusion requirement in bilateral TKA.