A Comparative Outcome Study Using Tranexamic Acid in Arthroscopic Medial Meniscectomy

Arthroscopic meniscectomy is an established procedure with known benefits in the correct patient population. Common complications associated with arthroscopic knee procedures are haemarthrosis, swelling, decreased range of motion, increased pain and infection. Previous methods for decreasing postoperative haemarthrosis and swelling have been drain placement and compressive dressings. TXA is a lysine based inhibitor of plasminogen to plasmin which has gained popularity in orthopaedic practice in the past decade after being shown to decrease blood loss. TXA administered intravenously has also been shown as safe with regards to events such as venous thromboembolism (VTE) and acute renal failure. A recent double blinded level 1 evidence prospective randomized controlled trial has also shown the benefit of TXA in arthroscopic ACL reconstructions in reducing postoperative hemarthrosis, swelling, and pain while increasing function in the short term. The safety of TXA has been well documented in the orthopaedic literature as well as other surgical fields for the purpose of reduction of blood loss. In 2006, a Cochrane review that included 65 trials that compared TXA versus control. These trials included a total of 4842 patients and showed that the use of TXA was not associated with an increased risk of MI, stroke, deep vein thrombosis (DVT), pulmonary embolism (PE) or renal failure. Specifically in the orthopaedic literature, a meta analysis compared the rate of VTE in patients undergoing knee and hip arthroplasty, none showing an increased risk of VTE associated with the use of TXA compared to control. Further to this, there are large joint registry retrospective cohort studies that have also shown no association with the use of TXA and increased risk of VTE. The goal of this pilot study is to determine if there is a role for TXA in improving short term results and patient satisfaction in arthroscopic knee meniscectomies.