Has Tranexamic Acid in Total Knee Arthroplasty Made Tourniquet Use Obsolete? Review uri icon

Overview

abstract

  • The application of tranexamic acid (TXA) in total joint arthroplasty has dramatically improved peri-operative blood management. In light of these benefits, a study by Huang et al., "Intravenous and Topical Tranexamic Acid Alone Are Superior to Tourniquet Use for Primary Total Knee Arthroplasty," evaluates the need for continued use of the intra-operative tourniquet, which remains a routine practice with documented benefits and adverse effects. This review evaluates the study's design and critically interprets its findings for clinical practice. Through a prospective, randomized trial, Huang et al. demonstrated that among selected patients undergoing primary total knee arthroplasty, the use of a tourniquet results in no reduction in blood loss beyond that provided by TXA alone. Moreover, the use of TXA without a tourniquet led to improved early clinical outcomes such as reduced post-operative swelling, improved knee range of motion at discharge, and enhanced patient satisfaction. As medicine is practiced in an increasingly value-driven environment, this study provides a useful method for evaluating the utility of commonly used interventions. Its findings highlight the need for future investigations into the optimal administration of TXA in total knee arthroplasty.

publication date

  • August 15, 2018

Identity

PubMed Central ID

  • PMC6148574

Scopus Document Identifier

  • 84908108927

Digital Object Identifier (DOI)

  • 10.1186/1749-799X-9-13

PubMed ID

  • 30258343

Additional Document Info

volume

  • 14

issue

  • 3