Efficay Of Extended Postoperative Iv Tranexamic Acid In Cases Of Total Knee Arthroplasty: A Retrospective Hospital Based Obervational Study

Abstract

Background: Total Knee Arthroplasty (TKA) is commonly associated with significant perioperative blood loss, pain, and delayed functional recovery. Tranexamic acid (TXA), an antifibrinolytic agent, has been widely used to reduce bleeding, but the efficacy of extended postoperative intravenous TXA administration remains underexplored. This study is to assess the effectiveness of prolonged postoperative intravenous TXA in improving pain, functional outcome and reducing post-operative complications in patients who underwent extended TXA therapy and those who adhered to normal guidelines.

Methods: This retrospective observational study was conducted at R.L. Jalappa Hospital, Kolar, from MAY 2025 to JULY 2025. Twenty patients who underwent TKA and received extended postoperative intravenous TXA were included. Baseline demographic data, pre- and postoperative hemoglobin levels, Knee Society Score (KSS), and Range of Motion (ROM) were recorded at baseline, 1 month, 3 months, and 6 months. Non-parametric tests (Friedman and Wilcoxon signed-rank) were used to assess longitudinal changes.

Results: There was a significant progressive improvement in KSS from a median of 38 at baseline to 66 at 6 months (p < 0.001). Similarly, ROM improved from a median of 90° to 120° (p < 0.001). Postoperative hemoglobin levels showed a minimal and controlled decline, with no transfusion requirement. All patients were mobilized within 48 hours postoperatively, and no thromboembolic or infective complications were observed.

Conclusion: Extended postoperative intravenous TXA administration in TKA significantly improves functional outcomes and ROM while reducing perioperative blood loss and maintaining a favourable safety profile. These findings support the incorporation of extended TXA regimens in enhanced recovery protocols for TKA.