The Value of Routine Intravenous Tranexamic Acid in Total Hip Arthroplasty: A Preliminary Study

Area of Science:

• Orthopedic Surgery
• Anesthesiology
• Hematology

Background:

• Blood loss during total hip arthroplasty (THA) can necessitate transfusions.
• Tranexamic acid (TXA) is an antifibrinolytic agent that may reduce surgical bleeding.

Purpose of the Study:

• To evaluate the efficacy of intraoperative intravenous tranexamic acid (TXA) in reducing transfusion requirements for patients undergoing total hip arthroplasty (THA).

Main Methods:

• A prospective, double-blind, randomized controlled trial involving 88 patients undergoing THA.
• Patients received either 1g of intravenous TXA or a placebo upon anesthesia induction, with spinal anesthesia used for all.
• Primary outcome was transfusion rate; secondary outcomes included blood loss, hemoglobin levels, hospital stay, functional scores, and thromboembolic events.

Main Results:

• The transfusion rate was 19.0% in the TXA group versus 20.5% in the placebo group (p=0.87).
• Mean intraoperative blood loss was 536.5 ml with TXA and 469.8 ml with placebo (p=0.87).
• No significant differences were observed in secondary outcomes between the groups.

Conclusions:

• Intraoperative intravenous administration of 1g TXA did not significantly decrease the need for blood transfusion in THA patients.
• TXA did not significantly impact postoperative blood loss, functional outcomes, or length of hospital stay in this cohort.