Topical Tranexamic Acid Reduces Blood Loss and Transfusion Rates in Total Hip and Total Knee Arthroplasty
Section snippets
Methods
Following approval of the University of Pittsburgh Medical Center's institutional review board, all patients undergoing primary THA and TKA over an eighteen month period by a single surgeon at a single institution were enrolled. This study evaluated a process change within our blood management program. The TXA group consists of all patients for one year after introducing a topical TXA protocol, and the control group consists of all the patients in the six months prior to implementing a topical
Results
From September 2010 until March 2011 all patients undergoing total joint arthroplasty did not receive any TXA. During this time 40 patients underwent primary unilateral THA, and 29 patients underwent primary unilateral TKA. All of these patients were included in the study. From March 2011 onwards, TXA was used in all cases. Between March 2011 and March 2012, 93 patients underwent primary unilateral THA, and 130 patients underwent primary unilateral TKA. All but two of these patients were
Discussion
Topical administration of TXA at the end of TKA and THA significantly reduced postoperative bleeding and risk for transfusion. The blood loss was 20 and 25% higher, respectively, in TKA and THA when TXA was not used. The drop in Hgb was 20 and 27% higher, respectively, in TKA and THA when TXA was not used. This translated into a much lower risk of requiring a blood transfusion in both the TKA and THA patients in which TXA was used. None of the TKA patients with TXA required a transfusion
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Cited by (0)
Financial support: This research was supported by a grant from the National Institutes of Health (T32GM075770).
Conflicts of Interest: none pertaining to the material in this manuscript.
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.06.011.