Effect of Oral + Topical and Only Topical Tranaxamic Acid Application on Blood Loss and Postoperative Transfusion in...

Objectives: Total hip arthroplasty is one of the most common procedures performed to reduce pain and improve hip functions in patients with advanced hip osteoarthritis, but perioperative blood loss, acute anemia and transfusion requirement increase the risk of morbidity and mortality during and after surgery and negatively affect functional recovery. We aimed to present the comparative results of oral + topical and only topical tranexamic acid application to reduce blood loss and postoperative transfusion in primary total hip arthroplasty. Methods: We retrospectively evaluated the patients who applied to the Orthopedics and Traumatology outpatient clinic with complaints of hip pain and limited movement between January 2014 and December 2020, who underwent primary total hip arthroplasty with the diagnosis of coxarthrosis and who were administered oral + topical and only topical tranexamic acid before and during surgery, in terms of blood loss and transfusion requirement. Results: No statistically significant difference was observed between the preoperative, day 0 and day 1 hemoglobin means in those that were applied oral + topical tranexamic acid and those that were applied only topical (p > 0.05). However, the second- and third-day hemoglobin means in those that were treated with topical medication alone were found to be statistically significantly lower than in those that were treated with oral + topical tranexamic acid (p = 0.032, p = 0.0001). Conclusions: Oral + topical tranexamic acid application in total hip arthroplasty surgery is more effective than topical applications alone when it comes to reducing blood loss, hemoglobin and hematocrit decrease without increasing the risk of thromboembolic diseases and wound complications.