NEW ORLEANS — A retrospective review of prospectively collected data presented here shows use of tranexamic acid is associated with a significant decrease in transfusion rates and no increase in venous thromboembolic events for patients undergoing either primary or revision hip or knee replacement.
“Tranexamic acid continues to support a decreased transfusion rate following both primary and revision hip and knee surgery without any increase in thromboembolic events,” Scott A. Wingerter, MD, PhD, said during his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Scott A. Wingerter
Wingerter and colleagues at Washington University School of Medicine performed a database search of all primary and revision hip and knee replacement surgeries to compare the transfusion rates and incidence of venous thromboembolic events (VTEs) before and after tranexamic acid (TXA) was routinely used at the center. According to Wingerter, there were no significant differences in demographic data between the pre-TXA and post-TXA groups. In the TXA cohort, investigators stratified patients into low-, intermediate- and high-risk groups for dosing. Postoperatively, all patients followed the institution’s anticoagulation protocol. Under this protocol, high-risk patients were given warfarin and wore compression stockings and standard-risk patients were prescribed aspirin and mechanical prophylaxis. Overall, the study included 1,320 hip cases and 886 knee cases.
The investigators found the transfusion rate for all hip cases combined was 41.7% pre-TXA, which decreased to 13% after TXA. The rate for knee cases decreased from 25% to 7%.
For the rate of VTEs, “there was no significant difference in the incidence at 4 weeks to 6 weeks or at 6 months. There was actually an absolute lower percentage in our patient group that was receiving TXA. There was only a 0.4% incidence in the TXA group compared to a 0.7% incidence in the non-TXA group at 6 months,” Wingerter said.
Wingerter SA. Paper #1. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
Disclosure: Wingerter has no relevant financial disclosures.