scholarly journals Intravenous versus Intra-Articular Tranexamic Acid in Primary Total Hip Arthroplasty: A Prospective Randomised Double Blinded Non-Inferiority Trial

2021 ◽  
Vol 11 ◽  
Author(s):  
Afsana Hasan ◽  
David Campbell ◽  
Peter Lewis
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Mode Of Delivery ◽  
Secondary Outcome ◽  
Total Hip ◽  
Significant Difference ◽  
Double Blinded ◽  
Primary Total Hip Arthroplasty

Introduction Tranexamic acid (TXA) has been shown to be effective in reducing post-operative blood loss after hip replacement surgery. Clinicians can be reluctant to administer intravenous (IV) TXA to high risk patients and intra-articular (IA) administration has been proposed as an alternative mode of delivery. This study was conducted to compare the efficacy of IV versus IA administration of TXA.   Methods This prospective, double blinded, randomised non-inferiority trial, compared 69 patients undergoing primary total hip arthroplasty (THA) who received either 3 doses of 15mg/kg of IV TXA or 3 g of IA TXA after capsular closure. The primary outcomes were change in Hb and the rate of blood transfusion. The secondary outcome was the rate of VTE.   Results The mean haemoglobin level change from pre-operative to day 1 post-operative for the IV group was 26.7g/L and for IA group was 27.3g/L. No statistically significant difference was detected between the two groups (p=0.82). No patients required a transfusion or developed a VTE.   Conclusions IA administration of TXA can be equally effective as IV in the reduction of blood loss and the prevention of post-operative anaemia in primary THA.

Effect of Multiple Doses of Oral Tranexamic Acid on Haemostasis and Inflammatory Reaction in Total Hip Arthroplasty: A Randomized Controlled Trial

2018 ◽  
Vol 119 (01) ◽  
pp. 092-103 ◽  
Author(s):  
Duan Wang ◽  
Yang Yang ◽  
Chuan He ◽  
Ze-Yu Luo ◽  
Fu-Xing Pei ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Inflammatory Response ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Multiple Dose ◽  
Control Group ◽  
Total Hip ◽  
Estimated Blood Loss ◽  
Significant Difference

AbstractTranexamic acid (TXA) reduces surgical blood loss and alleviates inflammatory response in total hip arthroplasty. However, studies have not identified an optimal regimen. The objective of this study was to identify the most effective regimen of multiple-dose oral TXA in achieving maximum reduction of blood loss and inflammatory response based on pharmacokinetic recommendations. We prospectively studied four multiple-dose regimens (60 patients each) with control group (group A: matching placebo). The four multiple-dose regimens included: 2-g oral TXA 2 hours pre-operatively followed by 1-g oral TXA 3 hours post-operatively (group B), 2-g oral TXA followed by 1-g oral TXA 3 and 7 hours post-operatively (group C), 2-g oral TXA followed by 1-g oral TXA 3, 7 and 11 hours post-operatively (group D) and 2-g oral TXA followed by 1-g oral TXA 3, 7, 11 and 15 hours post-operatively (group E). The primary endpoint was estimated blood loss on post-operative day (POD) 3. Secondary endpoints were thromboelastographic parameters, inflammatory components, function recovery and adverse events. Groups D and E had significantly less blood loss on POD 3, with no significant difference between the two groups. Group E had the most prolonged haemostatic effect, and all thromboelastographic parameters remained within normal ranges. Group E had the lowest levels of inflammatory cytokines and the greatest range of motion. No thromboembolic complications were observed. The post-operative four-dose regimen brings about maximum efficacy in reducing blood loss, alleviating inflammatory response and improving analgaesia and immediate recovery.

scholarly journals Effect of Additional Administration of Topical Tranexamic Acid in Patients Undergoing Primary Total hip Arthroplasty Without Drainage

2021 ◽  
Author(s):  
Jing Yao Jin ◽  
Qing Song Li ◽  
Taek Rim Yoon ◽  
Sheng Yu Jin ◽  
Min Gwang Kim ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Propensity Score ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Propensity Score Matching ◽  
Hip Arthroplasty ◽  
Total Blood ◽  
Total Hip ◽  
Topical Tranexamic Acid ◽  
Primary Total Hip Arthroplasty

Abstract Introduction: This study was designed to compare the clinical results of additional administration of topical tranexamic acid (TXA) with intravenous TXA (IV-TXA) and to determine its effect in patients undergoing primary total hip arthroplasty (THA) without drainage using propensity score matching analysis.Methods: A total of 248 patients (248 hips) underwent primary THA from March 2016 to June 2018. Patients who received topical TXA and IV-TXA were included in the combined group (46 patients), and patients who received IV-TXA were included in the IV only group (202 patients). After propensity score matching, both groups consisted of 44 patients (88 patients in total). We compared the results of total blood loss (TBL), haemoglobin (Hb) level, Hb drop, and the incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE). Results: In the combined group, the TBL was 280.4 ± 64.2 mL, which was significantly lower than that in the IV only group (335.3 ± 75.3 mL; p < 0.001). From the preoperative period to 1-week postoperatively, Hb levels were not significantly different between the two groups. There was significantly more Hb drop in the IV only Group from immediate postoperative to postoperative day 3 (POD 3). In both groups, no patient presented with postoperative symptomatic DVT or PE. Conclusion: In patients undergoing primary THA without drainage, combined use of IV-TXA and topical TXA can significantly decrease blood loss without influencing postoperative complications.

Two Doses of Intravenous Tranexamic Acid Offers No Benefit over One Dose in Total Hip Arthroplasty

2019 ◽  
Vol 04 (01) ◽  
pp. 001-006
Author(s):  
Ryan S. Charette ◽  
Jenna A. Bernstein ◽  
Matthew Sloan ◽  
Corbyn M. Nchako ◽  
Atul F. Kamath ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Univariate Analysis ◽  
High Volume ◽  
Primary Outcome Measure ◽  
Transfusion Rate ◽  
Total Hip ◽  
Significant Difference

AbstractTranexamic acid (TXA) has been shown to reduce blood loss and transfusions in total hip arthroplasty (THA). There is no consensus on the ideal number of doses that best reduces blood loss while limiting complications. Our study compared one versus two doses of intravenous TXA in primary THA and its effect on blood transfusion rate. We retrospectively reviewed patients undergoing primary THA at our two high-volume arthroplasty centers from 2013 to 2016. Patients were included if they underwent unilateral primary THA, and received one or two doses of TXA. Patients receiving therapeutic anticoagulation were excluded. Our primary outcome measure was postoperative transfusion rate. Secondary outcomes included blood loss, length of stay (LOS), rate of deep vein thrombosis/pulmonary embolism (DVT/PE), readmission, and reoperation. A total of 1,273 patients were included; 843 patients received one dose of TXA and 430 patients received two TXA doses. Univariate analysis demonstrated no significant difference in transfusion rate when administering one versus two doses. There was no significant difference in LOS, or rates of DVT/PE, readmission, and reoperation. When comparing patients receiving aspirin prophylaxis, there was a significantly decreased blood volume loss with two doses (1,360 vs. 1,266 mL, mean difference = 94 mL; p = 0.017). In patients, undergoing primary unilateral THA, there is no difference in postoperative transfusion rate with one or two doses of intravenous TXA. There was no difference in thromboembolic events. Given the added cost without clear benefit, these findings support one rather than two doses of TXA during primary THA.

scholarly journals Tranexamic acid administration to older patients undergoing primary total hip arthroplasty conserves hemoglobin and reduces blood loss

2018 ◽  
Vol 61 (3) ◽  
pp. 177-184 ◽  
Author(s):  
Hossam El Beheiry ◽  
Ashley Lubberdink ◽  
Nigel Clements ◽  
Kiran Dihllon ◽  
Vicky Sharma
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Total Hip ◽  
Acid Administration ◽  
Primary Total Hip Arthroplasty

Pharmacological reduction of bleeding during hip endoprosthetic replacement

2012 ◽  
Vol 153 (41) ◽  
pp. 1607-1612 ◽  
Author(s):  
Tamás de Jonge
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Red Cells ◽  
Postoperative Blood Loss ◽  
Total Hip ◽  
Group 2 ◽  
Primary Total Hip Arthroplasty ◽  
Group 1

Introduction: Endoprosthetic replacement of the large joints is accompanied by major bleeding. During the last few years several authors reported the perioperative administration of tranexamic acid and its beneficial effect on reducing the blood loss. Objectives: In the present study, the author studied the effect of intravenously administered tranexamic acid in patients undergoing primary total hip arthroplasty in order to examine whether this treatment could reduce postoperative blood loss, the amount of transfused packed red cells, and the cost of the blood saving and/or transfusion. Methods: The author compared retrospectively the data of 104 patients undergoing primary total hip arthroplasty between April, 2010 and December, 2011. 54 patients were administered tranexamic acid (Group 1) and 50 patients were treated without tranexamic acid (Group 2). The amount of postoperative bleeding, haemoglobin, hematocrit, red blood cell count, and the number of units of the transfused packed red cells were recorded. Cost effectiveness of treatment with tranexamic acid was calculated. Results: Postoperative blood loss in Group 1 was 732 ml (210–1280 ml), and in Group 2 1092 ml (420–2640 ml). Ten of the 54 patients in Group 1 had to be transfused, and the all-over need was 20 units of packed red cells. 49 of the 50 patients in Group 2 received 98 units of allogenic blood. Thromboembolic complication was not observed in connection with the use of tranexamic acid. The reduction of blood loss with the application of tranexamic acid and the transfused packed red cells cost in average 5,180 HUF per patient in Group 1 and 15,850 HUF in Group 2. Conclusions: Intravenous administration of tranexamic acid reduces effectively the transfusion rate and the blood loss in the postoperative period in patients undergoing primary total hip arthroplasty. More than 1.5 million HUF and 240 units of packed red cells could be yearly saved with the introduction of this simple, safe and cheap method of drug administered blood conservation. Orv. Hetil., 2012, 153, 1607–1612.

scholarly journals Topical Tranexamic Acid Reduces Blood Loss and Transfusion Rates Associated With Primary Total Hip Arthroplasty

2014 ◽  
Vol 472 (5) ◽  
pp. 1552-1557 ◽  
Author(s):  
Chih-Hsiang Chang ◽  
Yuhan Chang ◽  
Dave W. Chen ◽  
Steve W. N. Ueng ◽  
Mel S. Lee
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Total Hip ◽  
Topical Tranexamic Acid ◽  
Primary Total Hip Arthroplasty
Sign in / Sign up

Export Citation Format

Share Document