Transfusion rates with intravenous tranexamic acid in total hip arthroplasty performed using the direct anterior approach

Abstract

Introduction: Tranexamic acid (TXA) has been shown to reduce blood loss and transfusion requirements in patients undergoing total hip arthroplasty (THA). Most studies have focused on TXA in THA performed using a posterior approach (PA) or lateral approach. The aim of this study was to analyse the efficacy of TXA in patients undergoing THA using the direct anterior approach (DAA). Patients and methods: Using our institutional database, a retrospective analysis was conducted on consecutive primary THA performed for osteoarthritis to determine transfusion rates in patients undergoing THA with the DAA with and without TXA. Results: 146 consecutive THA were performed using DAA: 83 (56.8%) patients had TXA and 63 (43.2%) did not have TXA. Among patients who had TXA, 1 patient required a blood transfusion compared to 7 patients among those who did not have TXA (1.2% vs. 11.12%, p = 0.02). The relative risk of 0.11 (95% confidence interval 0.01–0.86) indicates an 89% reduction in the risk of requiring blood transfusion with TXA administration compared to no TXA. Conclusion: TXA is effective in reducing blood transfusion requirements for patients undergoing DAA THA.

Less Blood Loss With Tranexamic Acid in Primary Total Hip Arthroplasty Using the Direct Anterior Approach: a One-center Retrospective Observational Study

“…We speculate that the reason is that these patients in our study have a younger age, lower of BMI and shorter of operative time than those in Fraval et al [12] study. In addition, our results are not exactly the same as Free et al [13] study, they found that the transfusion rate after TXA was 1.2% in THA using DAA, which was signi cantly lower than the transfusion rate of 11.1% in the control group. We speculate that the reason is that these patients in our study have a younger age, lower of BMI and lower of ASA score than those in Free et al [13] study.…”

“…In addition, our results are not exactly the same as Free et al [13] study, they found that the transfusion rate after TXA was 1.2% in THA using DAA, which was signi cantly lower than the transfusion rate of 11.1% in the control group. We speculate that the reason is that these patients in our study have a younger age, lower of BMI and lower of ASA score than those in Free et al [13] study. Whether TXA can reduce the transfusion rate for THA via DAA requires more sample size and more prospective studies to determine.…”

“…Most studies have been performed on the posterolateral approach [11,17] or the lateral approach [18] or the posterior approach [19,20] in THA. However, there is less research on TXA in the DAA for THA [12,13]. This study aimed to explore whether TXA reduced perioperative blood loss and the rate of blood transfusion in patients undergoing THA via the DAA.…”

“…As a synthetic anti brinolytic agent, TXA has been shown to be effective in reducing blood loss and transfusion rate in THA [10,11]. However, few studies have explored the e cacy of TXA on perioperative blood loss in primary THA using the DAA [12,13] -in other words, it is still not known whether tranexamic acid is bene cial for the minimally invasive surgical approach to THA.…”

Efficacy and safety of tranexamic acid in unilateral major revision total hip arthroplasty

“…Tranexamic acid (TXA) reduces bleeding and transfusion in primary total hip arthroplasty (THA) without increasing the risk of venous thromboembolism (VTE) (1)(2)(3)(4)(5)(6). Compared with primary THA, revision THA usually causes more perioperative blood loss and transfusion because of more extensive exposure, longer operation time, and osteotomy.…”