title: Peri-operative blood-loss after total hip arthroplasty can be significantly reduced with topical application of epsilon-aminocaproic acid.
abstract: To evaluate the peri-operative blood loss with the use of epsilon-aminocaproic acid (ε-ACA) in total hip arthroplasty (THA).
  
  
  
  One hundred sixty patients treated with THA were followed; 5 g ε-ACA diluted in 100 ml normal saline was applied intra-operatively. Eighty patients not receiving ε-ACA (non ε-ACA group) and eighty patients receiving ε-ACA (ε-ACA group) were compared regarding blood loss, need of transfusion, and thrombo-embolic complications.
  
  
  
  Blood loss (mean ± SD) for the non ε-ACA group was 1678 ± 515 ml and for the ε-ACA group 1403 ± 417 ml (p < 0.05). In the non ε-ACA group 23 patients needed blood transfusions compared to ten patients in the ε-ACA group (p < 0.05). Cost savings were $284.39 per patient. No patient in either group developed a thrombo-embolic complication.
  
  
  
  This study demonstrates a significant reduction in peri-operative blood loss after THA with topically applied ε-ACA. The application of ε-ACA reduced costs by lowering transfusion rates and did not increase thrombo-embolic events. ε-ACA is safe and effective in reducing blood loss and cost-efficient in THA.
authors.affiliation: Department of Orthopaedics, University of California, Davis 4860 Y Street, Suite 3800, Sacramento, California, 95817, USA.
authors.forename: Mark G
authors.initials: MG
authors.lastname: Sucher
authors.affiliation: Department of Orthopaedics, University of California, Davis 4860 Y Street, Suite 3800, Sacramento, California, 95817, USA.
authors.forename: Mauro
authors.initials: M
authors.lastname: Giordani
authors.affiliation: School of Medicine, University of California, Davis Education Building, 4610 X Street, Sacramento, California, 95817, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Figoni
authors.affiliation: Department of Orthopaedics, University of California, Davis 4860 Y Street, Suite 3800, Sacramento, California, 95817, USA. nedopil@mytum.de.
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Nedopil
mesh_terms: D000287:Administration, Topical; D000368:Aged; D015119:Aminocaproic Acid / Q000627:therapeutic use*; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000379:methods; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology
chemical_list: D000933:Antifibrinolytic Agents; D015119:Aminocaproic Acid
keywords: Blood loss; Epsilon-aminocaproic acid; Total hip arthroplasty