Multiple Intravenous Tranexamic Acid Doses After Open Wedge-high Tibial Osteotomy(OW-HTO) Further Reduce Perioperative Blood Loss and Drainage Volume: A Retrospective Study

Abstract Background Studies have demonstrated the effectiveness and safety of tranexamic acid (TXA) in opening wedge high tibial osteotomy(OW-HTO). However, a consensus has not been established regarding the best dosing regimen and timing. In the present study, we aimed to compare three different dosages of intravenous (IV) TXA in OW-HTO.Material and methods A retrospective analysis of the clinical data obtained from patients administered with OW-HTO treatment for knee osteoarthritis from February 2016 to December 2019 was conducted. All operations were performed under general anaesthesia. TXA1 group (18 patients) received 1g of IV TXA administered 15 to 30 minutes pre-operation. TXA2 group (18 patients) received an additional dose of IV TXA (1g) 3 h after incision and the TXA3 group (18 patients) received an additional (third) dose 6 h later(1g). The blood loss and adverse events were compared between the three groups. Functional analysis, quality of life (QoL), and pain assessment were performed based on their corresponding scoring system.Results Baseline data were comparable for all groups. The postoperative drainage volume was calculated for the TXA3 group and the estimated blood loss was significantly reduced (p-value <0.05). The treatment effectively maintained postoperative Hb at a high level (p-value <0.05). In addition, a faster recovery, better QoL, reduced postoperative pain, and no complications were observed in patients belonging to the group TXA3.Conclusion Based on our results, three doses of IV TXA can effectively and safely reduce estimated blood loss and postoperative drainage volume in patients undergoing OW-HTO with additional associated benefits.