Topical administration of tranexamic acid in hip arthroplasty

The purpose of this study was to assess the efficacy of a newly designed topical administration of tranexamic acid (TXA) in reducing post-operative bleeding in total hip arthroplasty (THA) and bipolar hip hemiarthroplasty (BHA).

A consecutive series of 160 patients who underwent hip arthroplasty was enrolled in this study. Topical administration of TXA was done in group 1 (40 patients underwent THA and 40 BHA). We compared the amount of blood loss and rates of post-operative transfusion in group 1 with those of group 2 (40 cases of THA and 40 cases of BHA) in which TXA solution was not applied.

The total amount of blood loss in THA group 1 and THA group 2 was 793 ± 50 mL and 1086 ± 73 mL, respectively (p = 0.001). The transfusion rates of THA group 1 and THA group 2 was 27.5 % and 50 %, respectively (p = 0.039). The transfusion rates of BHA group 1 and BHA group 2 was 45 % and 60 %, respectively (p = 0.179). The amounts of blood loss through the drainage tube were 186 ± 22 mL and 257 ± 24 mL in THA group 1 and THA group 2, respectively, and 101 ± 11 mL and 147 ± 16 mL in BHA group 1 and BHA group 2, respectively, showing statistical significance. No complications such as infection, deep vein thrombosis or cardiovascular disease were observed during the hospital stay and the last follow-up.

Topical administration of TXA is an effective and safe method to reduce post-operative bleeding and transfusion rates in hip arthroplasty.