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J Arthroplasty. 2015 Aug;30(8):1354-8. doi: 10.1016/j.arth.2015.03.003. Epub 2015 Mar 14.

Topical Administration of Tranexamic Acid Plus Diluted-Epinephrine in Primary Total Knee Arthroplasty: A Randomized Double-Blinded Controlled Trial.

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Osteonecrosis and Joint-Preserving and Reconstruction Center, Beijing, China; Department of Orthopedic Surgery, Beijing, China; Beijing Key Laboratory of Arthritic and Rheumatic Diseases, Beijing, China; China-Japan Friendship Hospital, National Health and Family Planning Commission of the People's Republic of China, Beijing, China.


The aim of this trial was to evaluate the efficacy and safety of intra-articular administration of tranexamic acid (TXA) plus diluted-epinephrine (DEP) on perioperative blood loss and transfusion in primary unilateral total knee arthroplasty (TKA) without drainage. One hundred patients scheduled to undergo TKA were randomized into two groups: 50 patients received intra-articular 3g TXA plus 0.25mg DEP (1:200,000), and 50 patients received 3g topical TXA alone. The results showed that topical combined administration significantly reduced total blood loss (P=0.006), hidden blood loss (P=0.000) and transfusion rate (0% vs. 4%), without increasing the risk of thromboembolic and hemodynamic complications (P>0.05). Therefore, topical TXA plus DEP was effective and safe in reducing blood loss and transfusion following TKA, without substantial complications.


TKA; blood loss; epinephrine; topical; tranexamic acid; transfusion

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