scholarly journals Evaluation of tranexamic acid after total hip arthroplasty over 60 years old in China: a Systematic Review and Meta-analysis

2022 ◽  
Author(s):  
Pan Luo ◽  
◽  
Fuqiang Gao ◽  
Nianfei Zhang ◽  
Hongwei Yu ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Full Text ◽  
Meta Analysis ◽  
Measurement Data ◽  
Pooled Analysis ◽  
Transfusion Rate ◽  
Total Blood ◽  
Total Hip

Review question / Objective: The purpose of this meta-analysis was to evaluate the efficacy of tranexamic acid after total hip arthroplasty in patients older than 60 years old in China by meta-analysis. Participant or population: All trials included in our study meet the following criteria: (1) All studies were original RCTs; (2) The mean age of patients for each study was ≥ 60 years old; (3) Patients were received total hip arthroplasty in all studies; (4) All studies included oral and iv or topical groups, with a comparison of outcomes between the two groups; (5) The full text of the included literature can be obtained, and the measurement data of hemoglobin drop, total blood loss, transfusion rate, complication, length of stay can be extracted. The following studies were excluded from the meta-analysis: nonrandomized studies; the patients with age<60; studies not suitable with the inclusive criteria; and articles for which we were unable to obtain the full text and relevant data for pooled analysis.

scholarly journals Combined use of intravenous and topical tranexamic acid in patients aged over 70 years old undergoing total hip arthroplasty

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Junqing Jia
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Total Blood Loss ◽  
Transfusion Rate ◽  
Total Blood ◽  
Total Hip ◽  
Combined Use ◽  
Hemoglobin Drop

Abstract Purpose The present study was designed to evaluate the efficacy and safety of combined use of intravenous (IV) TXA administration and topical intraarticular tranexamic acid (TXA) strategy in patients aged over 70 undergoing total hip arthroplasty (THA). Methods One hundred eighty patients were randomized into three groups, including an IV group, a local group, and a combined group. Patients were administrated with 15 mg/kg of IV-TXA in the IV group, 2 g TXA in the topical group, or 15 mg/kg IV-TXA combined with 2 g TXA in the combined group. Total blood loss (TBL), maximum hemoglobin drop, the transfusion rate and the number of allogeneic blood units, and the incidence of deep venous thrombosis (DVT), and pulmonary embolism (PE) were recorded and analyzed. Results TBL was 757.75 ± 188.95 mL in the combined group, which was significantly lower than in the IV group (892.75 ± 218.47) or the topical group (1015.75 ± 288.71) (p = 0.015, p = 0.001 respectively). The mean values of maximum hemoglobin drop in the combined, IV, and topical groups were 2.67 ± 0.42, 3.28 ± 0.52, and 3.75 ± 0.62 g/dL, respectively, with a significant intergroup difference (p < 0.001 for all). PE was not detected within 1 month after the surgery. Asymptomatic DVT was reported in 1 patient of the IV group, and in 2 patients from the combined group, while the difference was not statistically significant. Conclusions Compared to intravenous or topical use of TXA, the combined therapy effectively decreased total blood loss and reduced the transfusion rate, simultaneously possessed the same degree of safety in primary THA patients aged over 70.

scholarly journals Less blood loss in supercapsular percutaneously assisted versus posterolateral total hip arthroplasty

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yong Hu ◽  
Min-Cong Wang ◽  
Tao Wang ◽  
Yue Meng ◽  
Xiao-Min Chao ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Hip Arthroplasty ◽  
Total Blood Loss ◽  
Transfusion Rate ◽  
Operative Blood Loss ◽  
Total Blood ◽  
Radiographic Findings ◽  
Total Hip ◽  
Affected Side

Abstract Background Although excellent clinical outcomes of supercapsular percutaneously assisted total hip arthroplasty (SuperPath) have been reported, the peri-operative blood loss has rarely been reported. The current study determined the blood loss during SuperPath and compared the blood loss with conventional posterolateral total hip arthroplasty (PLTH). Methods This retrospective study enrolled patients who underwent unilateral primary THA between January 2017 and December 2019. The demographic data, diagnoses, affected side, radiographic findings, hemoglobin concentration, hematocrit, operative time, transfusion requirements, and intra-operative blood loss were recorded. The peri-operative blood loss was calculated using the OSTHEO formula. Blood loss on the 1st, 3rd, and 5th post-operative days was calculated. Hidden blood loss (HBL) was determined by subtracting the intra-operative blood loss from the total blood loss. Results Two hundred sixty-three patients were included in the study, 85 of whom were in the SuperPath group and 178 in the posterolateral total hip arthroplasty (PLTH) group. Patient demographics, diagnoses, affected side, operative times, and pre-operative hemoglobin concentrations did not differ significantly between the two groups (all P > 0.05). Compared to the PLTH group, the SuperPath group had less blood loss, including intra-operative blood loss, 1st, 3rd, and 5th post-operative days blood loss, and HBL (all P < 0.05). Total blood loss and HBL was 790.07 ± 233.37 and 560.67 ± 195.54 mL for the SuperPath group, respectively, and 1141.26 ± 482.52 and 783.45 ± 379.24 mL for the PLTH group. PLTH led to a greater reduction in the post-operative hematocrit than SuperPath (P < 0.001). A much lower transfusion rate (P = 0.028) and transfusion volume (P = 0.019) was also noted in the SuperPath group. Conclusion SuperPath resulted in less perioperative blood loss and a lower transfusion rate than conventional PLTH.

scholarly journals Optimal use of tranexamic acid for total hip arthroplasty: A network meta-analysis

PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0206480 ◽  
Author(s):  
Byung-Ho Yoon ◽  
Tae-young Kim ◽  
Young Seung Ko ◽  
Young-Kyun Lee ◽  
Yong-Chan Ha ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Total Hip

scholarly journals Application of thromboelastography to evaluate the effect of different routes administration of tranexamic acid on coagulation function in total hip arthroplasty

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xingming Xu ◽  
Jiang Jiang ◽  
Wei Liu ◽  
Xiaofeng Li ◽  
Huading Lu
Keyword(s):  
Total Hip Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Hip Arthroplasty ◽  
Perioperative Complications ◽  
Control Groups ◽  
Total Blood ◽  
Total Hip ◽  
Coagulation Function ◽  
And Control

Abstract Background Tranexamic acid (TXA) is widely used to reduce blood loss and transfusion rates in total hip arthroplasty(THA). Thromboelastography, which can monitor coagulation changes from clotting to fibrinolysis dynamically. In this study, thromboelastography was used to assess the dynamic changes in the coagulation of patients who underwent THA with the administration of TXA. Methods This randomized controlled trial consisted of 207 consecutive patients who underwent primary total hip arthroplasty. Patients were randomized into three groups: topical-TXA group received a topical application of TXA, IV-TXA group received an intravenous injection of TXA, and control group. Thromboelastography was performed 1 day before surgery and first, fourth, seventh days after surgery. The primary outcomes were thromboelastography parameters, the rates of deep vein thrombosis(DVT), and pulmonary embolism(PE). Secondary outcomes included perioperative blood loss, transfusion rates, and other perioperative complications. Results The mean calculated total blood loss in the Topical-TXA group were 832.7 ± 279.84 ml and 834.8 ± 322.94 ml in the IV-TXA group, which were significantly reduced (p < 0.05) compared with control groups at 1093.3 ± 379.7 ml. There were no significant differences between topical-TXA and IV-TXA groups in total blood loss or transfusion rates. K and R have reached a nadir from preoperative levels to 4th day postoperatively and then began to increase.α angle and CI peaked from preoperative levels to the fourth day postoperatively and then began to decline.IV-TXA significantly (p < 0.05) promoted coagulation levels compared with topical-TXA and control groups in the early postoperative period. Almost no significant differences were observed between topical-TXA and control groups in thromboelastography parameters.No significant differences were observed in the incidence of thromboembolic complications and other perioperative complications. Conclusions The topical administration of TXA had the same hemostatic effect as intravenous injection tranexamic acid. Coagulation function peaked on 4th day postoperatively and then began to decline. IV-TXA was more enhanced coagulation functions compared with topical-TXA.

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.

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