Effects of tranexamic acid on postoperative knee activity and stress, and inflammation cytokines in patients undergoing total knee arthroplasty

Total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis, with postoperative bleeding and the inflammation-stress response being key factors that influence its outcomes. Tranexamic acid (TXA), an antifibrinolytic agent, has demonstrated efficacy in controlling perioperative bleeding. This study was to examine the effects of different doses of TXA on postoperative knee mobility and the inflammation–stress response in patients undergoing TKA

Ninety-eight patients undergoing unilateral TKA were randomly grouped based on the dose of TXA administered: 10 mg/kg (AG), 15 mg/kg (BG), and 20 mg/kg (CG). The bleeding, coagulation function, inflammation–stress cytokines, pain visual analogue scale (VAS) scores, knee mobility, and knee function hospital for special surgery (HSS) scores of the subjects were compared.

As the dose of TXA increased, the postoperative drainage volume, hidden bleeding, and total bleeding in TKA patients decreased, the levels of inflammatory factors interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α) were reduced, the levels of stress factors malondialdehyde (MDA), angiotensin II (Ang II), and cortisol (Cor) were reduced, pain VAS scores decreased, and knee mobility increased, with an increase in functional HSS scores (P < 0.05).

The administration of 20 mg/kg TXA in TKA patients visibly reduced bleeding following operation, improved the inflammation–stress response, and enhanced the function of the affected knee, which is beneficial to the postoperative recovery process.