OBJECTIVE: To explore whether all three ways (intra-articular injection, intravenous injection and their combination) to inject tranexamic acid can all effectively reduce the bleeding after total knee arthroplasty.

METHODS: 103 patients undergoing unilateral total knee arthroplasty from December 2014 to December 2015 were enrolled in this study. The patients were allocated into four groups according to injection way. In the intra-articular injection group, 2 000 mg of tranexamic acid was given through the intra-articular injection after incision suture. In the intravenous injection group, 1 000 mg of tranexamic acid was given through the intravenous injection at 15 minutes before the use of tourniquet. In the combined modality therapy group, above methods were used. In the blank control group, tranexamic acid was not given.

RESULTS AND CONCLUSION: (1) Total blood loss and blood transfusion rate were less in the intra-articular injection group and combined modality therapy group than in the intravenous injection group (P < 0.05). The total blood loss was more in the intra-articular injection group than in the combined modality therapy group (P > 0.05). The blood transfusion rate was 0% in the intra-articular injection group and combined modality therapy group. (2) Adverse reaction: deep vein thrombosis, pulmonary embolism, wound infection, hematoma or gangrene was not observed in all groups. (3) Results confirmed that intra-articular combined with intravenous injection can reduce effectively postoperative blood loss and the effect is better than separate administration. 
中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程