[Tranexamic acid reduces the blood loss in knee arthroplasty--if it's administered at the right time].

Blood loss in total knee arthroplasty is some-times profuse and often necessitates transfusion which is associated with a risk of disease transmission and immunological burden to the recipient. The fibrinolytic system is activated during surgery, an activation augmented by the tourniquet often used in knee arthroplasty. We have found tranexamic acid, a well-known fibrinolytic inhibitor, to reduce blood loss by half in total knee arthroplasty, and the need of transfusion by two thirds. For optimal efficacy, the tranexamic acid should be administered as prophylaxis before release of the tourniquet. We have found no adverse effects of the drug.