Topical (Intra-Articular) Tranexamic Acid Reduces Blood Loss and Transfusion Rates Following Total Hip Replacement

• DOI: 10.2106/jbjs.l.00908
• Publication Date: 2013-11-06T20:31:00Z
• Authors: Sattar Alshryda; James Mason; Praveen Sarda; Antoni Nargol; Nick Cooke; Hafeez Ahmad; S. Tang; Raj Logishetty; Manesh Vaghela; Lynne McPartlin; A. Pali S. Hungin
• Keywords: Antifibrinolytic

Background: Approximately one-third of patients undergoing total hip replacement surgery require one to three units blood postoperatively. Tranexamic acid is a synthetic antifibrinolytic agent that has been successfully used intravenously control bleeding after replacement. A topical application easy administer, provides maximum concentration tranexamic at the site, and associated with little or no systemic absorption acid. Methods: double-blind, randomized controlled trial 161 unilateral primary investigated effect (intra-articular) on loss. The outcome was transfusion rate. Secondary outcomes included drain loss, hemoglobin drop, generic quality life (EuroQol), Oxford Hip Score, length stay, cost analysis, complications. Results: reduced absolute risk by 19.6% (95% confidence interval [CI], 6.9% 32.1%; p = 0.004), from 32.1% 12.5%, loss 129 mL CI, 47 211 mL; 0.002), drop 0.84 g/dL 0.41 1.27; < 0.0001), stay 1.0 days −0.2 2.3 days; 0.109), per episode £305 £0 £610; 0.05). (In 2010, £1 1.5 U.S. dollars.) Scores EuroQol scores were similar months. Conclusions: Topically applied effective in reducing need for following replacement, avoiding potential complications intravenous administration. Level Evidence: Therapeutic I. See Instructions Authors complete description levels evidence.