Tranexamic acid decreases blood loss in total shoulder arthroplasty and reverse total shoulder arthroplasty

Abildgaard, Jeffrey T.; McLemore, Ryan; Hattrup, Steven J.

doi:10.1016/j.jse.2016.07.040

Cited by 3 publications

(8 citation statements)

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“…1–6,10 However, there have been relatively few studies evaluating TXA use in shoulder arthroplasty, 28 with no study to our knowledge reporting decreased transfusion rates with the use of TXA. 22–27 This study shows that perioperative TXA use is associated with a decreased risk for blood transfusion in shoulder arthroplasty patients with a low preoperative Hct.…”

Section: Discussionmentioning

confidence: 71%

“…24 in a randomized, prospective trial involving 111 patients demonstrated significantly lower postoperative drain output and significantly decreased haemoglobin change with the use of topical TXA. Friedman et al., 23 Abildgaard et al., 22 Vara et al., 27 and Pauzenberger et al. 26 similarly demonstrated decreased blood loss in patients receiving IV TXA.…”

Section: Discussionmentioning

confidence: 96%

“…Perioperative TXA has been proven safe in shoulder arthroplasty as a number of studies have demonstrated no increase in thromboembolic events. 22–27…”

Section: Discussionmentioning

confidence: 99%

“…Despite the decreased blood loss and higher postoperative Hct reported with the use of TXA in shoulder arthroplasty, there has not been an original study that reported statistically lower rates of blood transfusion postoperatively. 22–27 One recent meta-analysis showed that the treatment effect of TXA suggests a lower transfusion requirement with a relative risk of 0.45, but this had a wide confidence interval (0.18–1.09), which made the effect statistically insignificant. 35 The most recent meta-analysis using only randomized controlled trials was performed by delegates to the 2018 International Consensus Meeting on Musculoskeletal Infections.…”

Section: Discussionmentioning

confidence: 99%

“…These studies demonstrate decreased blood loss and higher postoperative Hct, but not a significant improvement in the transfusion rate. 22–27 Additionally, these studies only focus on primary shoulder arthroplasty and none of them evaluate any group that is at high risk for blood transfusion. In a position statement from the 2018 International Consensus Meeting on Musculoskeletal Infections, the authors state that the use of TXA has not been adequately studied in shoulder arthroplasty patients at a high risk of transfusion.…”

Section: Introductionmentioning

confidence: 99%

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Tranexamic acid use is associated with lower transfusion rates in shoulder arthroplasty patients with preoperative anaemia

et al. 2019

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Background: We evaluate tranexamic acid use in high-risk shoulder arthroplasty patients, hypothesizing that tranexamic acid will decrease transfusion rates in patients with low preoperative haematocrit. Methods: A retrospective review of shoulder arthroplasty patients with preoperative anaemia compared those treated with and without perioperative tranexamic acid. Inclusion criterion was any shoulder arthroplasty with a preoperative haematocrit (Hct) <38%. Tranexamic acid was given generally as 1 g intravenously before incision and 1 g during wound closure; topical tranexamic acid was used in cases of contraindication to IV tranexamic acid. Preoperative Hct, postoperative Hct, estimated blood loss, preoperative anticoagulation use, American Society of Anesthesiologist score, transfusion rate and demographic data were compared between groups with and without tranexamic acid. Results: Of the 435 arthroplasties performed, 109 patients had preoperative Hct < 38% (haemoglobin of 12.7 g/dL); 69 had tranexamic acid perioperatively and 40 did not. Demographics, anticoagulation use, diagnosis, arthroplasty types, estimated blood loss and preoperative Hct were similar between groups. The tranexamic acid group had a higher postoperative Hct, significantly lower transfusion rate and significantly smaller drop in Hct. Hct levels, Hct change and transfusion rate for topical versus intravenous tranexamic acid were not significantly different. Discussion: Perioperative tranexamic acid in high-risk shoulder arthroplasty patients with preoperative Hct <38% is associated with higher postoperative Hct and lower transfusion rates.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 96%

“…Perioperative TXA has been proven safe in shoulder arthroplasty as a number of studies have demonstrated no increase in thromboembolic events. 22–27…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tranexamic acid use is associated with lower transfusion rates in shoulder arthroplasty patients with preoperative anaemia

et al. 2019

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Topical and Intravenous Tranexamic Acid Are Equivalent in Decreasing Blood Loss in Total Shoulder Arthroplasty

Budge

2019

Journal of Shoulder and Elbow Arthroplasty

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Introduction: Tranexamic acid (TXA) has been shown to be an effective modality to decrease blood loss in total shoulder arthroplasty (TSA). However, the most effective method of TXA administration remains controversial. The purpose of this study was to directly compare the use intravenous and topical TXA to determine which regimen was more effective in improving postoperative hemoglobin (Hb), transfusion rates, and patient outcomes after primary TSA. Methods: We conducted a retrospective review of 3 sequential cohorts of patients undergoing primary TSA with no TXA, intravenous TXA, or topical TXA. Postoperative data collection included daily Hb levels (g/dL), transfusions, thromboembolic events, length of stay, and discharge disposition. One-way analysis of variance was used to compare data between the 3 groups with post hoc Tukey honestly significant difference test for differences between pairs. Results: Average change in Hb was 2.36 g/dL in the IV TXA group and 2.27 g/dL in the Topical TXA group which was not statistically significant (P ¼.69). Average change in Hb in the control group was 3.27 g/dL which was significant when compared to both TXA groups (P <.01). There were no transfusions or thromboembolic events in either TXA group. In the control group, there were 2 transfusions which was not statistically significant (P ¼.09). There was no significant difference in the discharge disposition or days in hospital between the 2 groups receiving TXA (P ¼.33). Conclusion: Intravenous and topical TXA are equivalent in improving postoperative Hb in TSA.

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Eficacia del ácido tranexámico para disminuir el sangrado perioperatorio en artroplastía total reversa primaria

Palmieri-Bouchan¹,

Aguirre-Rodríguez²,

Salinas-Vela³

et al. 2020

Acta Ortopédica Mexicana

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Tranexamic acid decreases blood loss in total shoulder arthroplasty and reverse total shoulder arthroplasty

Cited by 3 publications

References 0 publications

Tranexamic acid use is associated with lower transfusion rates in shoulder arthroplasty patients with preoperative anaemia

Tranexamic acid use is associated with lower transfusion rates in shoulder arthroplasty patients with preoperative anaemia

Topical and Intravenous Tranexamic Acid Are Equivalent in Decreasing Blood Loss in Total Shoulder Arthroplasty

Eficacia del ácido tranexámico para disminuir el sangrado perioperatorio en artroplastía total reversa primaria

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