Tranexamic Acid Reduces Blood Transfusions in Revision Total Hip Arthroplasty

Park, Kwan J.; Couch, Cory G.; Edwards, Paul; Siegel, Eric R.; Mears, Simon C.; Barnes, C. Lowry

doi:10.1016/j.arth.2016.05.058

Cited by 37 publications

(26 citation statements)

References 33 publications

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“…Previous studies have indicated that intravenous administration of tranexamic acid can significantly reduce blood loss and blood transfusion in revision hip arthroplasty 26,27 . Park et al have also confirmed this, but they excluded patients who had surgery for infection and PFF 21 . While Kazi et al classified patients according to the reason for revision.…”

Section: Discussionmentioning

confidence: 88%

“…Park et al . have also confirmed this, but they excluded patients who had surgery for infection and PFF. While Kazi et al .…”

Section: Discussionmentioning

confidence: 99%

“…Tranexamic acid has been well supported as an antifibrinolytic agent that safely and effectively reduces perioperative blood loss and rate of blood transfusions in primary THA 20,24 and provide similar benefits in the revision hip arthroplasty 21,22,[25][26][27] . However, there are several different types of revision hip arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

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Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study

Wang

Yeersheng

et al. 2019

Orthopaedic Surgery

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Objective To explore the efficacy and safety of intravenous tranexamic acid for reducing perioperative blood loss and allogeneic blood transfusions in revision surgery for Vancouver type B periprosthetic femoral fractures after total hip arthroplasty (THA). Methods We retrospectively reviewed 129 patients who underwent revision surgeries because of Vancouver type B periprosthetic femoral fractures from January 2008 to September 2018. Patients were divided into two groups according to whether they received intravenous tranexamic acid (n = 72) or not (n = 57). The two groups were compared in terms of estimated intraoperative blood loss, visible blood loss, hidden blood loss, the volume of allogeneic blood transfusion and the incidence of symptomatic venous thromboembolism (VTE). Patients were also compared depending on the Vancouver classification (Vancouver type B1, B2, and B3). Results Regardless of the subtype of Vancouver classification, patients who received tranexamic acid showed significantly lower estimated intraoperative blood loss, visible blood loss, hidden blood loss, and allogeneic blood transfusion volume. Use of tranexamic acid was not associated with significant changes in the incidence of postoperative symptomatic VTE. Similar results were obtained with subgroups of patients who had the Vancouver type B1, B2, or B3 periprosthetic femoral fractures. Conclusions The administration of intravenous tranexamic acid can safely and effectively reduce perioperative blood loss and allogeneic blood transfusions in revision surgery for Vancouver type B periprosthetic femoral fractures, without increasing the risk of symptomatic VTE.

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Section: Discussionmentioning

confidence: 88%

“…Park et al . have also confirmed this, but they excluded patients who had surgery for infection and PFF. While Kazi et al .…”

Section: Discussionmentioning

confidence: 99%

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Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study

Wang

Yeersheng

et al. 2019

Orthopaedic Surgery

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“…Various strategies have been used to minimize blood loss and allogenic blood transfusion during the perioperative period, such as autologous blood transfusion, controlled hypotension, and tranexamic acid (TXA) . TXA is a synthetic fibrinolytic inhibitor that reversibly binds to plasminogen and competitively inhibits both the binding of plasminogen to fibrin and its activation and transformation into plasmin .…”

mentioning

confidence: 99%

Synergistic effects of intravenous and intra‐articular tranexamic acid on reducing hemoglobin loss in revision total knee arthroplasty: a prospective, randomized, controlled study

Yuan

Wang

et al. 2018

Transfusion

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“…Eleven trials [13][14][15][20][21][22][23][24][25][26][27] were used in the meta-analysis of the transfusion requirements ( Figure 2.1). Significant heterogeneity was observed, and a random-effects model was used (I 2 = 73%, P < 0.0001).…”

Section: Allogenic Blood Transfusion Ratementioning

confidence: 99%

Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs

Zong

et al. 2019

Preprint

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Background: The use of tranexamic acid (TXA) during primary total joint arthroplasty （pTJA） is well documented. However, whether TXA is safe for patients undergoing revision total joint arthroplasty (rTJA) remains to be resolved. Methods: This meta-analysis included 12 studies that involved 2195 cases. The primary outcomes were indicators of TXA effectiveness during perioperative perid, including blood loss, haemoglobin (Hb) level changes, allogeneic blood transfusion (ABT) rate, and number of red blood cell (RBC) units transfused per patient. The secondary outcomes included thromboembolic complications, non-thromboembolic complications, and length of hospital stay. Results: TXA administration was associated with statistically significant decreases in the primary outcomes, including ABT rate (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.14–0.41; P < 0.00001), change in Hb level (mean difference [MD], −0.84; 95% CI, −1.28 to −0.41; P=0.002), and number of RBC units transfused per patient (MD, −0.49; 95% CI, −0.61 to −0.38; P < 0.00001) in the patients undergoing rTJA. Secondary outcome assessments showed no statistically significant differences in venous thromboembolism (OR, 0.99; 95% CI, 0.31–3.14; P=0.98) and non-thromboembolic complications (OR, 0.54; 95% CI, 0.18–1.68; P=0.29) between the patients who received and those who did not receive TXA in the revision total knee arthroplasty subgroup, while a significant decrease in length of hospital stay was found in those who received TXA (MD, −2.89; 95% CI, −4.85 to −0.93; P=0.004). Conclusion: In this meta-analysis, we found that the use of TXA acid can effectively reduce the number of blood transfusions in patients undergoing TJA without increasing the complication rate.

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Tranexamic Acid Reduces Blood Transfusions in Revision Total Hip Arthroplasty

Cited by 37 publications

References 33 publications

Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study

Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study

Synergistic effects of intravenous and intra‐articular tranexamic acid on reducing hemoglobin loss in revision total knee arthroplasty: a prospective, randomized, controlled study

Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs

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Tranexamic Acid Reduces Blood Transfusions in Revision Total Hip Arthroplasty

Cited by 37 publications

References 33 publications

Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study

Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study

Synergistic effects of intravenous and intra‐articular tranexamic acid on reducing hemoglobin loss in revision total knee arthroplasty: a prospective, randomized, controlled study

Is tranexamic acid effective and safe for patients undergoing revision total&nbsp;hip and knee&nbsp;arthroplasty: a meta-analysisIs

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Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs