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The use of tranexamic acid to reduce blood loss during total hip arthroplasty: an observational study
M C Hynes1, P Calder, P Rosenfeld
1Bone and Joint Research Unit, The Royal London Hospital, Whitechapel, London, UK. mchynes@hotmail.com
Introduction:
To test the hypothesis that the fall in haemoglobin following total hip arthroplasty is reduced by tranexamic acid administration.
Patients And Methods:
A cohort of 64 patients were studied, 32 received tranexamic acid 20 mg/kg on induction. Surgery was performed by the senior author in a standardised fashion. Haemoglobin levels were measured 2 weeks pre- and 3 days postoperatively. Any complications were noted. The study group was matched using the bone and joint research database for age, sex, procedure, disease and pre-operative haemoglobin level.
Results:
In the group receiving no tranexamic acid, the mean fall in haemoglobin was 3.8 g/dl (CI of mean 3.4-4.3) and in the group treated with tranexamic acid 2.8 g/dl (CI of mean 2.5-3.2) P < 0.05. Complications included one non-fatal pulmonary embolus in the tranexamic acid group.
Conclusions:
The administration of 20 mg/kg of tranexamic acid on induction of surgery is an effective method of reducing the haemoglobin fall following hip arthroplasty.

