title: Topical vs Intravenous Tranexamic Acid in Primary Total Hip Arthroplasty: A Double-Blind, Randomized Controlled Trial.
abstract: Tranexamic acid (TXA) reduces perioperative blood loss in total hip arthroplasty (THA).
  
  
  
  In our randomized control trial, 139 patients were enrolled and received 2 g of either topical or intravenous (IV) TXA. Preoperative and postoperative protocols were standardized.
  
  
  
  Calculated blood and Hgb loss were lower in the IV group (1195.0 ± 485.9 mL, 1442.7 ± 562.7 mL; P = .006), (160.3 [g] ± 63.8, 188.4 [g] ± 68.5; P = .014). There was a trend toward significance in transfusion reduction (11% [IV] vs 18% [topical]; P = .3). Both groups effectively reduced the transfusion rate. There was significant financial incentive for the use of TXA in THA with a savings of $314 per patient.
  
  
  
  IV and topical TXA are effective tools to reduce blood loss and transfusion costs in THA, and we recommend the IV form for ease of use.
authors.affiliation: Division of adult reconstructive surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Wayne T
authors.initials: WT
authors.lastname: North
authors.affiliation: Division of adult reconstructive surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Nima
authors.initials: N
authors.lastname: Mehran
authors.affiliation: Division of adult reconstructive surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Davis
authors.affiliation: Division of adult reconstructive surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Silverton
authors.affiliation: Division of adult reconstructive surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Robb M
authors.initials: RM
authors.lastname: Weir
authors.affiliation: Division of adult reconstructive surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Laker
mesh_terms: D061605:Administration, Intravenous; D000287:Administration, Topical; D000368:Aged; D000933:Antifibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid
keywords: cost reduction in primary hip arthroplasty; perioperative blood conservation; risk reduction in primary hip arthroplasty; total hip arthroplasty; tranexamic acid