Tranexamic Acid and Heterotopic Ossification Formation Following Elbow Surgery: A Prospective Randomized Controlled...

Area of Science:

• Orthopedic Surgery
• Traumatology
• Pharmacology

Background:

• Tranexamic acid (TXA) is utilized for its hemostatic and potential anti-inflammatory effects.
• Heterotopic ossification (HO) is a potential complication following surgery for elbow fracture dislocations.

Purpose of the Study:

• To investigate the effect of intraoperative intravenous tranexamic acid (TXA) on the incidence of heterotopic ossification (HO) after elbow fracture dislocation surgery.

Main Methods:

• Prospective, randomized clinical trial involving patients aged 18-75 years with acute traumatic elbow fracture dislocations.
• Patients were randomized to receive either intraoperative TXA or no additional treatment.
• Primary outcome was the occurrence of HO, assessed via radiographic exams; secondary outcomes included clinically relevant HO and reoperation rates.

Main Results:

• Of 47 patients, 43.5% in the TXA group developed HO compared to 16.7% in the control group (P=0.06).
• HO was primarily observed around the radial head.
• Two patients in the TXA group required reoperation due to symptomatic HO, versus none in the control group.

Conclusions:

• A possible increased risk of HO was identified with TXA use, though not statistically significant due to sample size.
• Larger prospective studies are recommended to definitively assess TXA's impact on HO formation.
• Findings emphasize the need to balance potential risks and benefits of TXA in orthopedic surgery.