Use of topical tranexamic acid during primary total hip arthroplasty could significantly reduce bleeding and transfusions without increasing the risk of deep vein thrombosis and pulmonary embolism, according to recently published findings.
Researchers randomly assigned 101 patients undergoing primary unilateral total hip arthroplasty (THA) to receive 3 g topical tranexamic acid (TXA) or to a control group. Primary outcomes included transfusion rate, the deep vein thrombosis and pulmonary embolism events, and secondary outcomes included total blood loss, drain blood loss, hemoglobin and hematocrit drop, postoperative hospitalization days and other complications. With the exception of height and BMI, no statistically significant differences were observed between the two groups preoperatively.
Results showed a significantly lower transfusion rate in the topical TXA group vs. the control group, according to the researchers. In the tranexamic group, mean total blood loss was 945.5 mL vs. 1255.5 mL in the control group.
Postoperative drain blood loss was significantly less in the topical TXA group, and hemoglobin and hematocrit drop in postoperative days 1 and 3 were also significantly lower vs. the control group, according to the researchers.
The researchers reported one asymptomatic deep vein thrombosis in the topical TXA group, and no pulmonary emboli events were found in either group. – by Casey Tingle
Disclosure: The authors have no relevant financial disclosures.