Efficacy of Tranexamic Acid on Perioperative Blood Loss in Hip Arthroplasty: A Comparative Study
-
Shantanu Vijay
,
Subham Verma
,
Bharat Soni
,
Tarun Desai
,
Prashant Alwani
,
Jeevan Kishor Appala
,
Chirag Valentine Thakkar
Abstract
Background: Using tranexamic acid (TXA) as a measure to ensure hemostasis during surgeries involving the hip region is a topic that is still debated, with scarce literature. The aim of this study was to assess the effectiveness of TXA administration in improving outcomes of hip arthroplasty.
Methods: This is a randomized comparative prospective study. It was conducted in the Department of Orthopedics, GMERS Medical College and Hospital, Vadodara, India, from January 2023 to December 2023 on 60 patients undergoing hip arthroplasty.
Results: The postoperative mean hemoglobin (Hb) value after 24 hours in the test group was 10.9 ± 1.6 g/dl while it was 10.1 ± 1.4 in the control group, which was statistically significant. The mean duration of surgery in the test group was 102.7 ± 28.2 minutes versus 125.2 ± 36.5 minutes in control with a P-value of 0.01, indicating less surgical duration in the test group.
Conclusion: TXA is an effective agent to reduce intraoperative blood loss, reduce surgical time, and improve post-operative Hb levels.
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8. Cohn MR, Levack AE, Trivedi NN, Villa JC, Wellman DS, Lyden JP, et al. The Hip Fracture Patient on Warfarin: Evaluating Blood Loss and Time to Surgery. J Orthop Trauma. 2017;31(8):407-13. doi: 10.1097/bot.0000000000000857. [PubMed: 28445186].
9. Nielson E, Hennrikus E, Lehman E, Mets B. Angiotensin axis blockade, hypotension, and acute kidney injury in elective major orthopedic surgery. J Hosp Med. 2014;9(5):283-8. doi: 10.1002/jhm.2155. [PubMed: 24464761].
10. Lerman DM, Rapp TB. Minimizing Blood Loss in Orthopaedic Surgery The Role of Antifibrinolytics. Bull Hosp Jt Dis (2013). 2015;73(2):83-9. [PubMed: 26517160].
11. Lin ZX, Woolf SK. Safety, Efficacy, and Cost-effectiveness of Tranexamic Acid in Orthopedic Surgery. Orthopedics. 2016;39(2):119-30. doi: 10.3928/01477447-20160301-05. [PubMed: 26942474].
12. Danninger T, Memtsoudis SG. Tranexamic acid and orthopedic surgery-the search for the holy grail of blood conservation. Ann Transl Med. 2015;3(6):77. doi: 10.3978/j.issn.2305- 5839.2015.01.25. [PubMed: 25992376]. [PubMed Central: PMC4416949].
13. Thorsen S, Clemmensen I, Sottrup-Jensen L, Magnusson S. Adsorption to fibrin of native fragments of known primary structure from human plasminogen. Biochim Biophys Acta. 1981;668(3):377-87. doi: 10.1016/0005-2795(81)90171-9. [PubMed: 7236714].
14. Ido K, Neo M, Asada Y, Kondo K, Morita T, Sakamoto T, et al. Reduction of blood loss using tranexamic acid in total knee and hip arthroplasties. Arch Orthop Trauma Surg. 2000;120(9):518-20. doi: 10.1007/s004029900132. [PubMed: 11011672].
15. Katsaros D, Petricevic M, Snow NJ, Woodhall DD, Van Bergen R. Tranexamic acid reduces postbypass blood use: a double- blinded, prospective, randomized study of 210 patients. Ann Thorac Surg. 1996;61(4):1131-5. doi: 10.1016/0003-4975(96)00022- 7. [PubMed: 8607670].
16. Wellington K, Wagstaff AJ. Tranexamic acid: a review of its use in the management of menorrhagia. Drugs. 2003;63(13): 1417-33. doi: 10.2165/00003495-200363130-00008. [PubMed: 12825966].
17. Gianakos AL, Hurley ET, Haring RS, Yoon RS, Liporace FA. Reduction of Blood Loss by Tranexamic Acid Following Total Hip and Knee Arthroplasty: A Meta-Analysis. JBJS Rev. 2018;6(5):e1. doi: 10.2106/jbjs.Rvw.17.00103. [PubMed: 29738409]. Moskal JT, Capps SG. Meta-analysis of Intravenous Tranexamic
2. Theusinger OM, Kind SL, Seifert B, Borgeat L, Gerber C, Spahn DR. Patient blood management in orthopaedic surgery: a four- year follow-up of transfusion requirements and blood loss from 2008 to 2011 at the Balgrist University Hospital in Zurich, Switzerland. Blood Transfus. 2014;12(2):195-203. doi: 10.2450/2014.0306-13. [PubMed: 24931841]. [PubMed Central: PMC4039701].
3. Sizer SC, Cherian JJ, Elmallah RD, Pierce TP, Beaver WB, Mont MA. Predicting Blood Loss in Total Knee and Hip Arthroplasty. Orthop Clin North Am. 2015;46(4):445-59. doi: 10.1016/j.ocl.2015.06.002. [PubMed: 26410634].
4. Mikhail C, Pennington Z, Arnold PM, Brodke DS, Chapman JR, Chutkan N, et al. Minimizing Blood Loss in Spine Surgery. Global Spine J. 2020;10(1 Suppl):71s-83s. doi: 10.1177/2192568219868475. [PubMed: 31934525]. [PubMed Central: PMC6947684].
5. Lee JH, Han SB. Patient Blood Management in Hip Replacement Arthroplasty. Hip Pelvis. 2015;27(4):201-8. doi: 10.5371/hp.2015.27.4.201. [PubMed: 27536627]. [PubMed Central: PMC4972790].
6. Carling MS, Jeppsson A, Eriksson BI, Brisby H. Transfusions and blood loss in total hip and knee arthroplasty: a prospective observational study. J Orthop Surg Res. 2015;10:48. doi: 10.1186/s13018-015-0188-6. [PubMed: 25889413]. [PubMed Central: PMC4383080].
7. Miao K, Ni S, Zhou X, Xu N, Sun R, Zhuang C, et al. Hidden blood loss and its influential factors after total hip arthroplasty. J Orthop Surg Res. 2015;10:36. doi: 10.1186/s13018- 015-0185-9. [PubMed: 25889223]. [PubMed Central: PMC4367912].
8. Cohn MR, Levack AE, Trivedi NN, Villa JC, Wellman DS, Lyden JP, et al. The Hip Fracture Patient on Warfarin: Evaluating Blood Loss and Time to Surgery. J Orthop Trauma. 2017;31(8):407-13. doi: 10.1097/bot.0000000000000857. [PubMed: 28445186].
9. Nielson E, Hennrikus E, Lehman E, Mets B. Angiotensin axis blockade, hypotension, and acute kidney injury in elective major orthopedic surgery. J Hosp Med. 2014;9(5):283-8. doi: 10.1002/jhm.2155. [PubMed: 24464761].
10. Lerman DM, Rapp TB. Minimizing Blood Loss in Orthopaedic Surgery The Role of Antifibrinolytics. Bull Hosp Jt Dis (2013). 2015;73(2):83-9. [PubMed: 26517160].
11. Lin ZX, Woolf SK. Safety, Efficacy, and Cost-effectiveness of Tranexamic Acid in Orthopedic Surgery. Orthopedics. 2016;39(2):119-30. doi: 10.3928/01477447-20160301-05. [PubMed: 26942474].
12. Danninger T, Memtsoudis SG. Tranexamic acid and orthopedic surgery-the search for the holy grail of blood conservation. Ann Transl Med. 2015;3(6):77. doi: 10.3978/j.issn.2305- 5839.2015.01.25. [PubMed: 25992376]. [PubMed Central: PMC4416949].
13. Thorsen S, Clemmensen I, Sottrup-Jensen L, Magnusson S. Adsorption to fibrin of native fragments of known primary structure from human plasminogen. Biochim Biophys Acta. 1981;668(3):377-87. doi: 10.1016/0005-2795(81)90171-9. [PubMed: 7236714].
14. Ido K, Neo M, Asada Y, Kondo K, Morita T, Sakamoto T, et al. Reduction of blood loss using tranexamic acid in total knee and hip arthroplasties. Arch Orthop Trauma Surg. 2000;120(9):518-20. doi: 10.1007/s004029900132. [PubMed: 11011672].
15. Katsaros D, Petricevic M, Snow NJ, Woodhall DD, Van Bergen R. Tranexamic acid reduces postbypass blood use: a double- blinded, prospective, randomized study of 210 patients. Ann Thorac Surg. 1996;61(4):1131-5. doi: 10.1016/0003-4975(96)00022- 7. [PubMed: 8607670].
16. Wellington K, Wagstaff AJ. Tranexamic acid: a review of its use in the management of menorrhagia. Drugs. 2003;63(13): 1417-33. doi: 10.2165/00003495-200363130-00008. [PubMed: 12825966].
17. Gianakos AL, Hurley ET, Haring RS, Yoon RS, Liporace FA. Reduction of Blood Loss by Tranexamic Acid Following Total Hip and Knee Arthroplasty: A Meta-Analysis. JBJS Rev. 2018;6(5):e1. doi: 10.2106/jbjs.Rvw.17.00103. [PubMed: 29738409]. Moskal JT, Capps SG. Meta-analysis of Intravenous Tranexamic
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| Issue | Vol 11 No 2 (2025) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v11i2.18880 | |
| Keywords | ||
| Total Hip Arthroplasty Tranexamic Acid Surgical Blood Loss Comparative Study | ||
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How to Cite
1.
Vijay S, Verma S, Soni B, Desai T, Alwani P, Appala J, Thakkar C. Efficacy of Tranexamic Acid on Perioperative Blood Loss in Hip Arthroplasty: A Comparative Study. J Orthop Spine Trauma. 2025;11(2):45-9.
