Intravenous tranexamic acid is associated with safe reduced blood loss and transfusion rate in one-stage exchange for infected hip arthroplasty

Abstract

Objectives This study aims to investigate if the use of intravenous (IV) tranexamic acid (TXA) during one-stage exchange for periprosthetic joint infection (PJI) of the hip that necessitates an extensive debridement is associated with decreased blood loss, if the rate of blood transfusion that may lead to side effects can be lowered with IV TXA, and if there is any difference regarding the occurrence of postoperative venous thromboembolism (VTE). Patients and methods We retrospectively reviewed patients who underwent one-stage exchange for PJI of the hip with perioperative IV administration of TXA (n=163; 90 males, 73 females; mean age 68±10.3; range, 25 to 90 years) between January 2015 and December 2016 and compared them to another group (n=190; 106 males, 84 females; mean age 71±10.1; range, 39 to 92 years) who underwent one-stage exchange for PJI of the hip without perioperative IV administration of TXA between January 2006 and December 2012. Blood loss, transfusion rates, amount of transfused blood, and occurrence of VTE complications were observed. Results Mean blood loss of the TXA group was significantly lower than that of the non-TXA group (2.4 L and 4.5 L, respectively; p<0.001). Patients in non-TXA group experienced significantly higher rate of blood transfusion (71.1% and 58.3%, respectively; p=0.014) and higher quantity of transfused packed red blood cells (3.2 and 1.9 units, respectively; p<0.001). There was one patient with VTE complication in each group. Conclusion Even in the presence of infection, usage of IV TXA during one-stage exchange for PJI of the hip is associated with significantly lower blood loss and transfusion rates showing no higher risk of VTE events.

The role of triclosan-coated suture in preventing surgical infection: A meta-analysis

“…It usually occurs due to the destruction of bone tissue structure and implantation of internal fixation during orthopedic surgery. [ 1 , 2 ] All surgeries are classified into four categories according to the wound classification system: clean, clean/contaminated, contaminated, and dirty. [ 3 ] Hip and knee arthroplasty is a type of clean operation in orthopedics; that is, the surgical incision does not involve inflammatory areas, respiratory tract, digestive tract, and urogenital tract.…”

Incidence and risk factors for blood transfusion in simultaneous bilateral total hip arthroplasty

“…Various methods to decrease perioperative blood loss associated with THA have been described in the literature. [32][33][34] Nevertheless, it is worth mentioning that, as this study consists of young and mostly male patients, findings should be cautiously interpreted and cannot be generalized to the main population of THA. In addition, this study has all limitations inherent to the retrospective design.…”

“…Various methods to decrease perioperative blood loss associated with THA have been described in the literature. [ 32 - 34 ]…”

Bilateral acetabular fracture secondary to high-velocity trauma: A rare case report

“…Additionally, the Tranexamic 1 g (an anti-fibrinolytic agent) was used preoperatively 1 g was infused 15 min prior the incision, was repeated after 3 h of operation and 6 h after the postoperation to reduce the intraoperative and postoperative blood loss without increasing the risk of thromboembolic events: this approach was consistent with the indication of tranexamic acid available in the literature. [ 26 , 27 ]…”