Higher Risks for Asian Patients Undergoing TKA?

Blood transfusion, deep vein thrombosis (DVT) and pulmonary embolism (PE)…how are they affected by tranexamic acid in Asian patients undergoing total knee arthroplasty (TKA)?

Those were the issues addressed in a recent study published in the January 2018 edition of Archives of Orthopaedic Trauma and Surgery. The study was entitled, “Does tranexamic acid increase the risk of thromboembolism after bilateral simultaneous total knee arthroplasties in Asian Population?”

Young-Hoo Kim M.D., professor and director of the Joint Replacement Center at SeoNam Hospital in Seoul, Republic of Korea, commented to OTW, “Our patient population has a very low incidence of DVT and PE without chemical thromboprophylaxis. We wanted to evaluate whether tranexamic acid (TXA) can increase DVT and PE without chemical thrombo-prophylaxis. We wanted to evaluate a large number of patients with or without TXA treatment.”

The authors wrote, “There were 874 patients (1748 knees) in the control group who did not receive tranexamic acid and 871 patients (1742 knees) in the study group who received tranexamic acid. Mechanical compression device was applied without any chemical thromboprophylaxis.”

“Intra- and post-operative blood loss and transfusion volumes were significantly lower in the tranexamic acid group. The prevalence of DVT was 14% (245 of 1748 knees) in the control group and 18% (314 of 1742 knees) in the tranexamic acid group. Pre- and post-operative perfusion lung scans revealed no evidence of PE in any patients in either group. Coagulation or thrombophilic data or molecular genetic testing was not significantly different between the two groups.”

Dr. Kim told OTW, “TXA did not increase the risk of DVT and PE with only mechanical compression device. TXA can be administered without chemical thromboprophylaxis. And TXA administration does not increase DVT or PE without chemical thromboprophylaxis.