Topical administration of tranexamic acid in hip arthroplasty

Int Orthop. 2017 Feb;41(2):259-263. doi: 10.1007/s00264-016-3195-2. Epub 2016 Apr 18.

Abstract

Purpose: The purpose of this study was to assess the efficacy of a newly designed topical administration of tranexamic acid (TXA) in reducing post-operative bleeding in total hip arthroplasty (THA) and bipolar hip hemiarthroplasty (BHA).

Methods: A consecutive series of 160 patients who underwent hip arthroplasty was enrolled in this study. Topical administration of TXA was done in group 1 (40 patients underwent THA and 40 BHA). We compared the amount of blood loss and rates of post-operative transfusion in group 1 with those of group 2 (40 cases of THA and 40 cases of BHA) in which TXA solution was not applied.

Results: The total amount of blood loss in THA group 1 and THA group 2 was 793 ± 50 mL and 1086 ± 73 mL, respectively (p = 0.001). The transfusion rates of THA group 1 and THA group 2 was 27.5 % and 50 %, respectively (p = 0.039). The transfusion rates of BHA group 1 and BHA group 2 was 45 % and 60 %, respectively (p = 0.179). The amounts of blood loss through the drainage tube were 186 ± 22 mL and 257 ± 24 mL in THA group 1 and THA group 2, respectively, and 101 ± 11 mL and 147 ± 16 mL in BHA group 1 and BHA group 2, respectively, showing statistical significance. No complications such as infection, deep vein thrombosis or cardiovascular disease were observed during the hospital stay and the last follow-up.

Conclusion: Topical administration of TXA is an effective and safe method to reduce post-operative bleeding and transfusion rates in hip arthroplasty.

Keywords: Hip arthroplasty; Post-operative bleeding; Topical administration; Tranexamic acid.

MeSH terms

  • Administration, Topical
  • Aged
  • Aged, 80 and over
  • Antifibrinolytic Agents / administration & dosage*
  • Arthroplasty, Replacement, Hip / adverse effects
  • Arthroplasty, Replacement, Hip / methods*
  • Blood Transfusion / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / epidemiology
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / prevention & control*
  • Tranexamic Acid / administration & dosage*

Substances

  • Antifibrinolytic Agents
  • Tranexamic Acid