Tranexamic acid versus fibrin sealant in primary total hip replacement: a comparative study

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Hematology

Background:

• Intravenous tranexamic acid (TA) is recognized for reducing blood loss in total hip replacement (THR).
• This study compares the efficacy of fibrin sealant against intravenous TA and a control group in THR procedures.

Purpose of the Study:

• To evaluate the effectiveness of fibrin sealant in reducing blood loss during THR.
• To compare fibrin sealant with intravenous tranexamic acid (TA) and a control group for blood loss and transfusion needs.

Main Methods:

• Prospective study of 273 patients undergoing primary hip osteoarthritis THR.
• Three groups: control (n=73), fibrin sealant (n=100), and intravenous TA (n=100).
• Data collected on blood loss and allogeneic transfusion requirements.

Main Results:

• Both fibrin sealant and intravenous TA significantly reduced blood loss compared to the control group (15% and 22.5% reduction, respectively).
• Neither fibrin sealant nor TA was superior in preventing blood loss (p=0.39).
• Tranexamic acid significantly decreased allogeneic transfusion requirements compared to fibrin sealant (0% vs. 10%, p=0.05).

Conclusions:

• Fibrin sealant and intravenous tranexamic acid are both effective in reducing blood loss during THR.
• Tranexamic acid demonstrates superiority in reducing post-operative transfusion requirements.