Topical administration of tranexamic acid in primary total hip and total knee arthroplasty.
Major blood loss is a known potential complication in total hip and total knee arthroplasty. We conducted a prospective, stratified, randomized, double-blind, placebo-controlled trial that evaluated 100 patients undergoing total knee or total hip arthroplasty to evaluate the effect on blood loss using the topical application of tranexamic acid. Participants received either 2 g of topical tranexamic acid or the equivalent volume of placebo into the joint prior to surgical closure. Tranexamic acid resulted in a lower mean maximum decline in postoperative hemoglobin levels when compared to placebo (P = 0.013). Patients in the tranexamic acid group demonstrated an improved but non-significant reduction in the units of blood transfused compared to placebo (P = 0.423). There was no clinically significant increase in complications in the tranexamic acid group, including no incidence of venous thromboembolism.
ORA Orthopedics PC, Bettendorf, Iowa.
Joseph G
JG
Martin
Genesis Medical Center at West Central Park, Department of Pharmaceutical Services, Davenport, Iowa.
Kevin B
KB
Cassatt
Genesis Medical Center at West Central Park, Department of Pharmaceutical Services, Davenport, Iowa.
Katie A
KA
Kincaid-Cinnamon
Genesis Health System, Davenport, Iowa.
Denise S
DS
Westendorf
Genesis Health System, Davenport, Iowa.
Ann S
AS
Garton
Genesis Health System, Davenport, Iowa.
Jon H
JH
Lemke
D000287:Administration, Topical; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*
D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
blood loss; blood transfusion; hemoglobin; total hip arthroplasty; total knee arthroplasty; tranexamic acid