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Data from a study conducted in China and published in The Journal of Bone & Joint Surgery suggest that tourniquet may not be necessary when tranexamic acid (TXA) is available to reduce blood loss during primary total knee arthroplasty (TKA). 

The authors conducted a prospective, randomized, controlled trial of 150 patients who were treated with either tourniquet as well as multiple doses of intravenous TXA and one dose of topical TXA (n = 50), intravenous and topical TXA (n = 50), or tourniquet with no TXA (n = 50). They found that total intraoperative blood loss was similar across all cohorts. However, patients in the TXA only group saw significantly less hidden blood loss, reduced postoperative swelling and levels of inflammatory biomarkers, and improved visual analog scale pain score, range of motion at discharge, Hospital for Special Surgery score, and patient satisfaction. Learn more...