Topical Tranexamic Acid Reduces Blood Loss and Transfusion Rates Associated With Primary Total Hip Arthroplasty

Abstract

Background Systemic tranexamic acid can decrease blood loss and rates of transfusion in patients undergoing total hip arthroplasty (THA). However, the efficacy of topical tranexamic acid in THA has only recently been characterized in a small number of studies. Questions/purposes The purpose of this study was to compare (1) the greatest hemoglobin decrease after surgery;(2) transfusion rates; and (3) symptomatic thromboembolic events among patients undergoing THA who did and did not receive topical tranexamic acid.

Additional intraarticular tranexamic acid further reduced postoperative blood loss compared to intravenous and topical bathed tranexamic acid in total hip arthroplasty: a retrospective sequential series study

“…In the first phase of the study, additional IV TXA injection reduced postoperative blood loss compared with patients with only topical bathed TXA. The potential advantages of topical application of TXA were direct targeting of the site of bleeding and prevention of systemic adverse effects . Several studies reported that topical use of TXA (10 mg/kg; 3 g) was also effective in reducing postoperative blood loss in THA .…”

“…Recently, the growing perioperative use of tranexamic acid (TXA) demonstrated its efficacy in reducing blood loss and postoperative transfusions after THA . Several investigators sought to elicit the clinical outcomes of TXA in total joint arthroplasty, and the majority of their studies utilized intravenous (IV) administration of TXA, many of which involved the administration of multiple doses .…”

“…IV administration of TXA leads to its distribution throughout the body fluids and has possible systemic adverse effects; however, several systemic reviews and meta‐analyses did not find an increased thromboembolic risk associated with IV TXA . Topical TXA administration was also shown to be effective in reducing blood loss in THA . Some studies have shown that intraarticular TXA administration was as effective as IV dosing.…”

“…Some studies have shown that intraarticular TXA administration was as effective as IV dosing. Topical TXA was focused on effectiveness compared with effect of IV TXA and had the advantage of less potential for systemic complications . These studies suggested that TXA administration was safe and effective in reducing postoperative blood loss in THA.…”

Administration of Tranexamic Acid Reduces Postoperative Blood Loss in Calcaneal Fractures: A Randomized Controlled Trial

“…Its efficacy in reducing intraoperative and postoperative blood loss is documented in cardiac surgery, hip and knee replacement surgery, and spinal surgery (10)(11)(12)(13). Most of the previous studies have had poor reliability owing to the variability in the studies.…”