Is tranexamic acid safe for the hip joint?

Naunyn Schmiedebergs Arch Pharmacol. 2024 Feb;397(2):1197-1207. doi: 10.1007/s00210-023-02693-1. Epub 2023 Aug 30.

Abstract

To show the effects of tranexamic acid, which is a drug frequently used to control bleeding, on the hip joint and sciatic nerve in animal experiments. There were 15 rats in each of the 3 groups, with a total of 45 rats. Topical saline injections were applied to the first group, topical TXA injections to the second group, and intravenous (IV) TXA injections to the third group. In the samples taken from the hip joint 3 weeks later, femoral head cartilage, sciatic nerve, and joint capsule thicknesses were analyzed histologically. Statistically significantly more cartilage degradation was detected in the femoral head cartilage in both the IV and intraarticular TXA group when compared to the control group. The groups were also compared in terms of acetabular cartilage; however, no histological difference was found between the groups. It was seen that when the femoral head cartilage thickness (the average of the measurements made from 3 different points were used) was examined, the cartilage thickness in the topical TXA group was less when compared to the other 2 groups. However, this difference was determined to not be statistically significant. The data of the hip joint capsule thickness measurement, it was found that the capsule thickness in the topical TXA applied group was less when compared to the other 2 groups. However, this difference was not statistically significant. When the sciatic nerves in all 3 groups were compared, no different staining characteristics were found in the immunofluorescence examination. TXA, which is frequently used in orthopedic practice, shows negative effects on hip joint cartilage in both topical and intravenous application.

Keywords: Cartilage; Hip; Hip joint; Sciatic nerve; Tranexamic acid.

MeSH terms

  • Administration, Intravenous
  • Administration, Topical
  • Animals
  • Antifibrinolytic Agents*
  • Arthroplasty, Replacement, Hip*
  • Blood Loss, Surgical
  • Hip Joint
  • Rats
  • Tranexamic Acid*

Substances

  • Tranexamic Acid
  • Antifibrinolytic Agents