Background
Blood loss after total knee arthroplasty (TKA) is not something to neglect especially if it is bilateral. A lot of measures can be taken to reduce this blood loss such as tourniquets, autologous transfusion, and closed suction drains.
Purpose
The use of closed suction drains in TKA has downsides such as introducing a foreign body to the wound, increasing nursing care, etc. This leads to the question whether this use can be replaced by other modalities such as the use of tranexamic acid injections.
Patients and methods
Two groups of 13 patients undergoing bilateral TKA were compared. The first group had tranexamic acid injections while the other had closed suction drains. The number of transfusions and the hemoglobin drop 1 and 2 days postoperatively were assessed and compared between both groups.
Results
The hemoglobin drop both on the first and second day after the surgery were higher in the group operated with a closed suction drainage (P=0.000162 and 0.01512, respectively). The number of transfusions was also higher in the group operated with closed suction drainage (18 compared with four transfusions needed in the other group).
Conclusion
The use of drains may be replaced by tranexamic acid injections in bilateral TKA.