Tranexamic Acid Reduces Transfusion Rates After Modular Hemiarthroplasty for Pathological Femoral Fractures: A...

Area of Science:

• Orthopedic Surgery
• Oncology
• Hematology

Background:

• Femoral fractures from bone metastasis complicate cancer treatment.
• Modular prostheses offer tumor control and functional improvement but cause significant blood loss.
• Blood transfusions carry risks like infection and prolonged hospital stays.

Purpose of the Study:

• To evaluate the efficacy of tranexamic acid (TXA) in reducing blood loss and transfusion requirements in patients with pathological femoral fractures.
• To assess the safety profile of TXA in this patient population.

Main Methods:

• Retrospective analysis of 82 patients with pathological femoral fractures treated with resectional prostheses between 2017 and 2021.
• Comparison of outcomes between patients who received TXA prophylaxis (2020-2021) and those who did not (2017-2019).
• Evaluation of total blood loss, hemoglobin drop, transfusion rates, and thromboembolic events.

Main Results:

• Patients receiving TXA showed higher postoperative hemoglobin levels (0.99 g/dL increase, p=0.03).
• TXA reduced blood loss by 217 mL (p=0.09) and significantly decreased transfusion rates from 43% to 17% (p=0.04).
• No significant differences in complication rates were observed between groups.

Conclusions:

• TXA is an effective and safe adjunct for reducing blood loss and transfusion needs in surgeries for pathological femoral fractures.
• The use of TXA can mitigate the risks associated with blood transfusions in these complex cases.