title: Longtime soaking of high concentration tranexamic acid in total hip arthroplasty: A prospective randomized controlled trial in 224 patients.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of intra-articular Soaking of high concentration Tranexamic Acid (TXA) in total hip arthroplasty.
  
  
  METHODS
  From March 2013 to March 2014, 224 patients who underwent unilateral primary THA in our hospital was enrolled in this randomized, prospective double-blinded study. The patients were allocated into two groups according to intra-articular solution received: Intra-articular soaking of TXA group, Control group (physiologic saline). The solution was injected from intermuscular space following fixation of the implants and closure of articular capsule, short external rotators. Total blood loss, total volume of drainage and transfusion were recorded. Postoperative deep vein thrombosis and other complications was also measured.
  
  
  RESULTS
  The mean total blood loss was 730±296 ml in intra-articular soaking of TXA group compared with 1048±295ml in control group (P<0.05). The postoperative mean total volume of drainage was 93±50 mL in intra-articular soaking of TXA group versus 312±136 mL in control group.22 patients (19.8%, control) and 6 patients (5.3%, Intra-articular soaking of TXA) required transfusion (P=0.001). Postoperative deep vein thrombosis and other complications were no statistical significance between the two groups.
  
  
  CONCLUSIONS
  Intra-articular soaking of high concentration TXA with 2-hour clamping drain can reduce the total blood loss and transfusion rates in primary THA without significant increase in postoperative thrombotic complications.
authors: Xingming Xu, MD. Medical College of Nanchang University, Nanchang University, No.461, Bayi Street, 330000 Nanchang, China.
authors: Xingming
authors: X
authors: Xu
authors: Xiaofeng Li, MD. Dept. of Orthopaedics, The First Affiliated Hospital of Nanchang University, Nanchang University, No.17, Yongwai Street, 330006 Nanchang, China.
authors: Xiaofeng
authors: X
authors: Li
authors: Wei Liu, MD. Medical College of Nanchang University, Nanchang University, No.461, Bayi Street, 330000 Nanchang, China.
authors: Wei
authors: W
authors: Liu
authors: Zhenyu Wang, MD. Medical College of Nanchang University, Nanchang University, No.461, Bayi Street, 330000 Nanchang, China.
authors: Zhenyu
authors: Z
authors: Wang
keywords: Intra-articular soaking; Total blood loss; Total hip arthroplasty; Tranexamic Acid