The topical application of tranexamic acid in patients undergoing total knee and hip arthroplasty resulted in a significant decline in blood loss and no measureable side effects, according to study results.
Researchers randomly assigned 50 patients undergoing total knee arthroplasty (TKA) and 50 patients undergoing total hip arthroplasty (THA) to receive either 2 g tranexamic acid (TXA) or the equivalent volume of placebo into the joint space prior to surgical closure to evaluate the effect on blood loss. Primary outcome measures included the maximum decline in postoperative hemoglobin, and secondary outcomes included the number of patients who received packed red blood cell transfusions, the average length of hospital stay, number of postoperative wound infections and number of patients diagnosed with deep vein thrombosis or pulmonary embolism within 30 days of surgery.
Postoperative hemoglobin had a significantly lower maximum decline when topical TXA was used (P = .013). The researchers found trends toward reductions in blood transfusion rates when using TXA, with 14.3% of patients who received TXA undergoing transfusion compared with 20% of patients who received placebo. Furthermore, 38.8% fewer units of blood per patient were administered in the TXA group.
Overall, 30-day readmission rates were lower among the TXA treatment group. The researchers found no differences in average length of hospital stay and no venous thromboembolism events or surgical site infections between the two groups.
Disclosure: Martin and Cassatt received research support from Genesis Medical Center.