Reduction of Blood Loss with Tranexamic Acid in Primary Total Hip Replacement Surgery

Claeys, M A; Vermeersch, Nick; Haentjens, Patrick

doi:10.1080/00015458.2007.11680081

Cited by 114 publications

(91 citation statements)

References 19 publications

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“…10,12 The fibrinolytic response after surgery is biphasic. 4,13 The initial phase of increased fibrinolytic activity lasts one hour and is followed by fibrinolytic shutdown, which peaks again after about 24 hours. This is a consequence of increased release of plasminogen activator inhibitor.…”

Section: Discussionmentioning

confidence: 99%

“…1 The effects of TA on intra-and post-operative blood loss in patients undergoing cemented or uncemented THA have been reported. [1][2][3][4][5][6][7][8][9] We assessed the effects of a single dose of intravenous TA in patients undergoing THA on intra-operative blood loss, postoperative reduction in haemoglobin and haematocrit levels, blood transfusion, incidence of deep vein thrombosis, and the length of hospital stay.…”

Section: Introductionmentioning

confidence: 99%

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Effects of Tranexamic Acid on Blood Loss during Total Hip Arthroplasty

Singh

Ballal

Mitchell

et al. 2010

J Orthop Surg (Hong Kong)

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Purpose. To assess the effects of tranexamic acid (TA) in patients undergoing total hip arthroplasty (THA) for osteoarthritis. Methods. 42 patients underwent primary THA for osteoarthritis by a single surgeon. 10 men and 11 women who did not receive TA were controls, whereas 9 men and 12 women who received TA constituted the treatment group. Both groups were matched for age, gender, body mass index, and American Society of Anesthesiologists grading. The type of prosthesis used (cemented or uncemented) was based on the surgeon's preference and patient age, activity level and demands. No hybrid prosthesis was used. 10 minutes prior to incision, a single dose of intravenous TA (10 mg per kg body weight) was given to patients in the treatment group. Comparison was made between both groups with regard to intra-operative blood loss, postoperative reduction in haemoglobin and haematocrit levels, blood transfusion, incidence of deep vein thrombosis, and the length of hospital stay. Results. The mean intra-operative blood loss (489±281 vs. 339±184 ml, p=0.048) and the decrease in haemoglobin level (38±12 vs. 29±10 g/l, p=0.014) were significantly higher in the control than the treatment group. Two patients among the controls received a transfusion, compared to none in the TA group (p=0.49, Fisher's exact test). The 2 patients who needed blood transfusion had blood losses of 600 and 690 ml, compared to a mean of 489 ml in the whole group. No patient in either group developed deep vein thrombosis or pulmonary embolism up to 3 months. Conclusion. A single dose of intravenous TA (10 mg per kg body weight) given 10 minutes prior to THA is a cost-effective and safe means of minimising blood loss and reduction in haemoglobin concentrations as well as the need for allogenic blood transfusion, without increasing the risk of thromboembolic events.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Tranexamic Acid on Blood Loss during Total Hip Arthroplasty

Singh

Ballal

Mitchell

et al. 2010

J Orthop Surg (Hong Kong)

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“…So far, a large number of methods for controlling bleeding transfusions were successfully used following TKA, which included autologous blood transfusion, intraoperative blood saving and hypotensive anesthesia [5,7,8].…”

Section: Introductionmentioning

confidence: 99%

Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty

Digas¹,

Koutsogiannis²,

Meletiadis³

et al. 2015

Eur J Orthop Surg Traumatol

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The purpose of this study was to compare the efficacy of intravenous and topical tranexamic acid (TXA) versus control group for reduction in blood loss following primary total knee arthroplasty (TKA). A total of 90 patients were prospectively allocated to each of three groups (control, intravenous IV and intra-articular) and underwent unilateral total knee arthroplasty. In the IV group, patients received one dose of TXA of 15 mg/kg before deflation of the tourniquet, while in the intra-articular group patients received 2 g TXA via the drain retrogradely after closure of the wound. The mean drained blood loss in control, IV and intra-articular groups was 415 ± 24, 192 ± 21 and 121 ± 17 ml, respectively. About 43 % (control), 23 % (IV) and 17 % (intra-articular) of each group required transfusion, and the mean transfusion was 338, 168 and 79 ml, respectively. Preoperative hemoglobin values decreased at 24 h by 2.80 ± 0.14, 2.24 ± 0.17 and 2.26 ± 0.18 mg/dl, respectively. TXA reduced blood loss and transfusion requirement. Compared with one-dose intravenous administration, intra-articular administration of TXA seems to be more effective in terms of reducing drained blood loss and transfusion frequency. We recommend administration of topical TXA in primary TKA in healthy patients to decrease perioperative blood loss.

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“…To reduce this risk, multiple studies have focused on techniques to reduce blood loss in primary THA, with varying results [4,17,[20][21][22][23][24][25][26][27][28][29]. In a meta-analysis conducted by Rosenchner et al [30], the mean expected blood loss in primary THA was found to be 1944 mL.…”

Section: Discussionmentioning

confidence: 98%

Prospective, Randomized Trial to Evaluate Efficacy of a Bipolar Sealer in Direct Anterior Approach Total Hip Arthroplasty

Suárez

Slotkin

Szubski

et al. 2015

The Journal of Arthroplasty

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Reduction of Blood Loss with Tranexamic Acid in Primary Total Hip Replacement Surgery

Abstract: Tranexamic acid 15 mg/kg given as a single preoperative bolus dose reduces postoperative and total blood loss, and packed cell transfusion requirements in primary total hip replacement surgery.

Cited by 114 publications

References 19 publications

Effects of Tranexamic Acid on Blood Loss during Total Hip Arthroplasty

Effects of Tranexamic Acid on Blood Loss during Total Hip Arthroplasty

Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty

Prospective, Randomized Trial to Evaluate Efficacy of a Bipolar Sealer in Direct Anterior Approach Total Hip Arthroplasty

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