Journal of Orthopedics and Joint Surgery

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VOLUME 2 , ISSUE 2 ( July-December, 2020 ) > List of Articles

Original Article

Does Intra-articular Tranexamic Acid Decrease Blood Loss in Total Hip Arthroplasty?

Ganesan Ram Ganesan, Phagal Varthi Vijayaraghavan

Citation Information : Ganesan GR, Vijayaraghavan PV. Does Intra-articular Tranexamic Acid Decrease Blood Loss in Total Hip Arthroplasty?. 2020; 2 (2):49-51.

DOI: 10.5005/jp-journals-10079-1022

License: CC BY-NC 4.0

Published Online: 13-04-2021

Copyright Statement:  Copyright © 2020; The Author(s).


Background: Blood is the nurturing liquid that delivers oxygen to the cells of the body and removes carbon dioxide and waste from the body. Blood is considered as liquid gold. Total hip replacement causes blood loss and in turn needs blood transfusion. The aim of the study is to find the role of intra-articular tranexamic acid (TXA) in control of blood loss in total hip replacement surgeries. Materials and methods: A prospective study of 50 patients who underwent total hip replacement surgery. The study group and control group patients were selected through the card method. In the study group after the skin closure, 2 g of TXA was injected through the drain tube and drain tube was clamped for 1 hour and then released. Blood loss during the first and second postoperative periods from suction drain was calculated. Results: Four hundred and fifty-five milliliters was the mean first postoperative day blood collected in the drain tube in the control group while study group had 283 mL. Similarly, the second day mean postoperative day drain was 89 mL in control group and 25 mL in study group. The mean first and second postoperative day blood loss was statistically significant between the groups. Discussion: There was a considerable reduction of transfusions in postoperative period; hence, there was a reduced hospitalization cost and less risk of transmitted infections and transfusion reactions. There is a negligible risk of thrombosis in patients who had intravenous TXA not the intra-articular TXA. Conclusion: Intra-articular TXA is an effective tool in controlling blood loss and reducing blood transfusions in hip replacement surgeries.

  1. Blood transfusion in total hip athroplasty: guidelines toeliminate overtransfusion. Can J Anaesth 1993;40(3):222–226. DOI: 10.1007/BF03037034.
  2. Recommendations for the transfusion of red blood cells. Blood Transfus 2009;7(1):49. DOI: 10.2450/2008.0020-08.
  3. Tranexamic acid and total hip arthroplasty: optimizing the administration method. Ann Transl Med 2016;4(24):530. DOI: 10.21037/atm.2016.11.53.
  4. Efficacy and safety of tranexamic acid in total hip replacement: a PRISMA-compliant meta-analysis of 25 randomized controlled trials. Medicine 2017;96(52). DOI: 10.1097/MD.0000000000009552.
  5. Surgeons often underestimate the amount of blood loss in replacement surgeries. Chin J Traumatol 2014;17(4):225–228.
  6. Tranexamic acid reduces postoperative blood loss in cementless total hip arthroplasty. J Bone Joint Surg Am 2005;87(4):766–770. DOI: 10.2106/JBJS.D.02046.
  7. Prophylactic tranexamic acid and epsilon-aminocaproic acid for primary myocardial revascularization. ATS 1998;65(2):371–376. DOI: 10.1016/s0003-4975(97)01016-3.
  8. The effect of epsilon aminocaproic acid on blood loss in patients who undergo primary total hip replacement: a pilot study. Can J Surg 2002;45(3):185–190.
  9. Tranexamic acid for treatment and prophylaxis of bleeding and hyperfibrinolysis. Wien Klin Wochenschr 2017;129(9-10):303–316. DOI: 10.1007/s00508-017-1194-y.
  10. Intravenous versus topical tranexamic acid in total knee arthroplasty: both effective in a randomized clinical trial of 640 patients. J Bone Joint Surg Am 2018;100(12):1023–1029. DOI: 10.2106/JBJS.17.00908.
  11. Topical vs intravenous tranexamic acid in primary total hip arthroplasty: a double-blind, randomized controlled trial. J Arthroplasty 2016;31(5):1022–1026. DOI: 10.1016/j.arth.2015.11.003.
  12. Reduction of blood loss in orthopaedic surgery. In orthopaedic proceedings. Br Editor Soc Bone Joint Surg 2006;88(No. Supp_I):17–17.
  13. Tranexamic acid administration is associated with an increased risk of posttraumatic venous thromboembolism. J Trauma Acute Care Surg 2019;86(1):20–27. DOI: 10.1097/TA.0000000000002061.
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