The Effectiveness of Tranexamic Acid in Patients With Proximal Femoral Tumor Resection Prosthesis

Aim: The aim of this study is to evaluate the risk of thromboembolic events and amount of postoperative blood loss and transfusion in patients who received preoperative tranexamic acid (TXA) administration in proximal femoral resection and endoprosthesis of proximal femur malignant lesion.

Methods: In this study, the data of 46 patients who underwent extensive resection and proximal femoral tumor prosthesis for proximal femoral bone malignancies were retrospectively reviewed. Patients were divided into two groups according to preoperative 15 mg/kg bolus intravenous administration of TXA. These patients were compared in terms of postoperative blood loss, postoperative bleeding, and transfusion requirements.

Results: There were 46 patients (18 female, 28 male) with a mean age of 60.7±14.7 (19-89) years. Fifteen patients (32.6%) were treated with iv TXA. In the TXA group (46.7%), there was a statistically significant decrease in the need for transfusion compared to the patient group (93.5%) without TXA (p=0.001). Postoperative 24th hour, 48th hour,and total drainage blood loss values were found to be significantly lower in the TXA group (p=0.047, p=0.015, and p=0.019, respectively). There was no thromboembolic event observed.

Conclusion: Because of proximal femoral malignancy, extensive tumor resection and preoperative bolus 15 mg/kg TXA administration in proximal femoral prosthesis surgery significantly decreased the amount of postoperative bleeding and transfusion requirement without increasing the risk of thromboembolic event.

Level of evidence: Level III - retrospective comparative study.