title: What Is the Benefit of Tranexamic Acid vs Reinfusion Drains in Total Joint Arthroplasty?
abstract: We sought to compare the efficacy and cost of reinfusion drains vs tranexamic acid (TA) in primary total joint athroplasty (TJA) patients. We randomized 186 primary TJAs (71 hips, 115 knees) to standard drains (61/186), autologous reinfusion drains (60/186), or single dose (20 mg/kg) of TA (65/186). There was a statistically significant (P < .0001) less drop in hemoglobin levels (2.98 mg/dL; range, 0.5-6.10) in the TA group compared with standard drains (P < .0001) and reinfusion drains (P < .0061). There was no significant difference in transfusion rates. At $581.89, the unit cost of the reinfusion system is substantially higher than the standard drain ($7.56) and TA ($35.91/g). The results of this randomized controlled trial demonstrate that TA is more efficacious and provides cost savings compared with reinfusion drains as a blood management tool for TJA.
authors.affiliation: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Springer
authors.affiliation: OrthoCarolina Research Institute, Charlotte, North Carolina.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Odum
authors.affiliation: OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Fehring
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000933:Antifibrinolytic Agents / Q000008:administration & dosage*; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001804:Blood Transfusion, Autologous / Q000379:methods*; D004322:Drainage / Q000379:methods*; D004921:Erythropoietin / Q000008:administration & dosage; D005260:Female; D017048:Health Care Costs; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*
chemical_list: D000933:Antifibrinolytic Agents; D006454:Hemoglobins; D004921:Erythropoietin; D014148:Tranexamic Acid; D007501:Iron
keywords: allogenic blood; blood loss; randomized clinical trial; total joint arthroplasty; transexamic acid