The Efficacy of Low - Dose Intravenous Tranexamic Acid in Reducing Postoperative Blood Loss in Arthroscopic Anterior Cruciate Ligament Reconstruction
Abstract
Purpose: This prospective, randomized, double-blind study aimed to assess the efficacy of single intravenous administration of low-dose tranexamic acid (TXA) in arthroscopic anterior cruciate ligament reconstruction (ACLR) for minimizing postoperative blood loss. Secondary objectives included assessing early postoperative pain levels, range of knee flexion, knee joint hemarthrosis, and TXA-associated complications.
Methods: Sixty patients undergoing arthroscopic ACLR were randomly assigned to either the treatment group (n = 30), receiving a single bolus dose of 10 mg/kg TXA intravenously 10 minutes before surgery, or the control group (n = 30), receiving an equal volume of normal saline via the same route. The volume of drained blood was measured at 3 and 24 hours postoperatively. Hemarthrosis grade was assessed in postoperative weeks 1 and 2. Pain levels were evaluated using a visual analog scale (VAS) at postoperative day 1, week 1, and week 2. Knee flexion range was recorded at the end of postoperative week 2 and week 4.
Results: Patient demographics were comparable between the two groups. Postoperative reductions in hemoglobin (TXA group 1.10 ± 0.52, control group 1.80 ± 0.71, p<0.001) and hematocrit (TXA group 3.42 ± 1.74, control group 5.41 ± 2.04, p<0.001) were statistically significant in favor of the TXA group. The mean postoperative VAS scores, range of knee flexion, and hemarthrosis grades were similar between the groups. No postoperative complications were reported.
Conclusion: Single intravenous administration of low-dose TXA effectively reduces postoperative blood loss in arthroscopic anterior cruciate ligament reconstruction (ACLR) surgery. However, this intervention did not demonstrate clinical benefits in terms of pain levels, range of motion, or knee hemarthrosis during the early postoperative period. Additional research may be warranted to explore optimal TXA dosing strategies and its impact on functional outcomes in ACLR patients.
Keywords : Tranexamic acid, arthroscopy, ACL reconstruction, hemarthrosis
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