Efficacy of Tranexamic Acid Application for Blood Loss Reduction in Total Hip Arthroplasty

2010 ◽  
Vol 17 (1) ◽  
pp. 29-34
Author(s):  
R M Tikhilov ◽  
I I Shubnyakov ◽  
M I Mokhanna ◽  
D G Pliev ◽  
A A Myasoedov ◽  
...  

Prospective study of tranexamic acid use results (native preparation Tranexam) in primary total hip arthroplasty was performed during the period from March to October 2009. The study involved 159 patients (55 men, 104 women) with various hip joint pathology (79 patients - main group, 80 patients - control group). Mean age of patients made up 55.7 years (17 - 80 years). In patients from the main group 15 mg/kg Tranexam was injected just prior to operation with reinjection of the same dose in 6 hours. In control group etamsylate (750 mg 30 minutes prior to incision with reintroduction in 4 - 6 hours, daily dose up to 1500 mg) was applied. The results of the analysis showed reliable (p

2021 ◽  
Vol 103-B (7 Supple B) ◽  
pp. 111-115
Author(s):  
Rushabh M. Vakharia ◽  
Angelo Mannino ◽  
Hytham S. Salem ◽  
Martin W. Roche ◽  
Che Hang J. Wong ◽  
...  

Aims Although there is increasing legalization of the use of cannabis in the USA, few well-powered studies have evaluated the association between cannabis use disorder and outcomes following primary total hip arthroplasty (THA). Thus, the aim of this study was to determine whether patients who use cannabis and undergo primary THA have higher rates of in-hospital length of stay (LOS), medical complications, implant-related complications, and costs. Methods Using an administrative database, patients with cannabis use disorder undergoing primary THA were matched to a control group in a 1:5 ratio by age, sex, and various medical comorbidities. This yielded 23,030 patients (3,842 in the study group matched with 19,188 in the control group). The variables which were studied included LOS, 90-day medical complications, two-year implant-related complications, and 90-day costs of care. Mann-Whitney U tests were used to compare LOS and costs. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) of developing complications. Results We found that patients in the study group had a significantly longer mean LOS compared with the controls (four days vs three days; p < 0.0001).The study group also had a significantly higher incidence and odds of developing medical (23.0 vs 9.8%, OR 1.6; p < 0.0001) and implant-related complications (16 vs 7.4%, OR 1.6; p < 0.0001) and incurred significantly higher mean 90-day costs ($16,938.00 vs $16,023.00; p < 0.0001). Conclusion With the increasing rates of cannabis use, these findings allow orthopaedic surgeons and other healthcare professionals to counsel patients with cannabis use disorder about the possible outcomes following their THA, with increased hospital stays, complications, and costs. Cite this article: Bone Joint J 2021;103-B(7 Supple B):111–115.


2018 ◽  
Vol 29 (5) ◽  
pp. 451-457 ◽  
Author(s):  
Yuangang Wu ◽  
Yi Zeng ◽  
Xianchao Bao ◽  
Huazhang Xiong ◽  
Xiwei Fan ◽  
...  

2018 ◽  
Vol 119 (01) ◽  
pp. 092-103 ◽  
Author(s):  
Duan Wang ◽  
Yang Yang ◽  
Chuan He ◽  
Ze-Yu Luo ◽  
Fu-Xing Pei ◽  
...  

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.


2018 ◽  
Vol 47 (5) ◽  
Author(s):  
Sherif Dabash ◽  
Leticia C. Barksdale ◽  
Colin A. McNamara ◽  
Preetesh D. Patel ◽  
Juan C. Suarez

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