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Erschienen in: International Orthopaedics 2/2017

18.04.2016 | Original Paper

Topical administration of tranexamic acid in hip arthroplasty

verfasst von: Joon Soon Kang, Kyoung Ho Moon, Bom Soo Kim, Seong Jo Yang

Erschienen in: International Orthopaedics | Ausgabe 2/2017

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Abstract

Purpose

The purpose of this study was to assess the efficacy of a newly designed topical administration of tranexamic acid (TXA) in reducing post-operative bleeding in total hip arthroplasty (THA) and bipolar hip hemiarthroplasty (BHA).

Methods

A consecutive series of 160 patients who underwent hip arthroplasty was enrolled in this study. Topical administration of TXA was done in group 1 (40 patients underwent THA and 40 BHA). We compared the amount of blood loss and rates of post-operative transfusion in group 1 with those of group 2 (40 cases of THA and 40 cases of BHA) in which TXA solution was not applied.

Results

The total amount of blood loss in THA group 1 and THA group 2 was 793 ± 50 mL and 1086 ± 73 mL, respectively (p = 0.001). The transfusion rates of THA group 1 and THA group 2 was 27.5 % and 50 %, respectively (p = 0.039). The transfusion rates of BHA group 1 and BHA group 2 was 45 % and 60 %, respectively (p = 0.179). The amounts of blood loss through the drainage tube were 186 ± 22 mL and 257 ± 24 mL in THA group 1 and THA group 2, respectively, and 101 ± 11 mL and 147 ± 16 mL in BHA group 1 and BHA group 2, respectively, showing statistical significance. No complications such as infection, deep vein thrombosis or cardiovascular disease were observed during the hospital stay and the last follow-up.

Conclusion

Topical administration of TXA is an effective and safe method to reduce post-operative bleeding and transfusion rates in hip arthroplasty.
Literatur
1.
Zurück zum Zitat Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB (1999) An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am 81:2–10CrossRefPubMed Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB (1999) An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am 81:2–10CrossRefPubMed
2.
Zurück zum Zitat Kumar A (2009) Perioperative management of anemia: limits of blood transfusion and alternatives to it. Cleve Clin J Med 76:112–118CrossRef Kumar A (2009) Perioperative management of anemia: limits of blood transfusion and alternatives to it. Cleve Clin J Med 76:112–118CrossRef
3.
4.
Zurück zum Zitat Hoylaerts M, Lijnen HR, Collen D (1981) Studies on the mechanism of the antifibrinolytic action of tranexamic acid. Biochim Biophys Acta 673:75–85CrossRefPubMed Hoylaerts M, Lijnen HR, Collen D (1981) Studies on the mechanism of the antifibrinolytic action of tranexamic acid. Biochim Biophys Acta 673:75–85CrossRefPubMed
5.
Zurück zum Zitat Lemaire R (2008) Strategies for blood management in orthopaedic and trauma surgery. J Bone Joint Surg (Br) 90:1128–1136CrossRef Lemaire R (2008) Strategies for blood management in orthopaedic and trauma surgery. J Bone Joint Surg (Br) 90:1128–1136CrossRef
6.
Zurück zum Zitat Forget P, Grosu I, Thienpont E (2013) Inadequate methodology renders results on the use of tranexamic acid inconclusive. Int Orthop 37:1417–1418CrossRefPubMedPubMedCentral Forget P, Grosu I, Thienpont E (2013) Inadequate methodology renders results on the use of tranexamic acid inconclusive. Int Orthop 37:1417–1418CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Benoni G, Fredin H, Knebel R, Nilsson P (2001) Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in 40 primary operations. Acta Orthop Scand 72:442–448CrossRefPubMed Benoni G, Fredin H, Knebel R, Nilsson P (2001) Blood conservation with tranexamic acid in total hip arthroplasty: a randomized, double-blind study in 40 primary operations. Acta Orthop Scand 72:442–448CrossRefPubMed
8.
Zurück zum Zitat Husted H, Blønd L, Sonne-Holm S, Holm G, Jacobsen TW, Gebuhr P (2003) Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients. Acta Orthop Scand 74:665–669CrossRefPubMed Husted H, Blønd L, Sonne-Holm S, Holm G, Jacobsen TW, Gebuhr P (2003) Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients. Acta Orthop Scand 74:665–669CrossRefPubMed
9.
Zurück zum Zitat Moráis S, Ortega-Andreu M, Rodríguez-Merchán EC, Padilla-Eguiluz NG, Pérez-Chrzanowska H, Figueredo-Zalve R, Gómez-Barrena E (2014) Blood transfusion after primary total knee arthroplasty can be significantly minimised through a multimodal blood-loss prevention approach. Int Orthop 38:347–354CrossRefPubMed Moráis S, Ortega-Andreu M, Rodríguez-Merchán EC, Padilla-Eguiluz NG, Pérez-Chrzanowska H, Figueredo-Zalve R, Gómez-Barrena E (2014) Blood transfusion after primary total knee arthroplasty can be significantly minimised through a multimodal blood-loss prevention approach. Int Orthop 38:347–354CrossRefPubMed
10.
Zurück zum Zitat Johansson T, Pettersson LG, Lisander B (2005) Tranexamic acid in total hip arthroplasty saves blood and money: a randomized, double-blind study in 100 patients. Acta Orthop 76:314–319PubMed Johansson T, Pettersson LG, Lisander B (2005) Tranexamic acid in total hip arthroplasty saves blood and money: a randomized, double-blind study in 100 patients. Acta Orthop 76:314–319PubMed
11.
Zurück zum Zitat Yamasaki S, Masuhara K, Fuji T (2004) Tranexamic acid reduces blood loss after cementless total hip arthroplasty—prospective randomized study in 40 cases. Int Orthop 28:69–73CrossRefPubMed Yamasaki S, Masuhara K, Fuji T (2004) Tranexamic acid reduces blood loss after cementless total hip arthroplasty—prospective randomized study in 40 cases. Int Orthop 28:69–73CrossRefPubMed
12.
Zurück zum Zitat Ido K, Neo M, Asada Y, Kondo K, Morita T, Sakamoto T, Hayashi R, Kuriyama S (2000) Reduction of blood loss using tranexamic acid in total knee and hip arthroplasties. Arch Orthop Trauma Surg 120:518–520CrossRefPubMed Ido K, Neo M, Asada Y, Kondo K, Morita T, Sakamoto T, Hayashi R, Kuriyama S (2000) Reduction of blood loss using tranexamic acid in total knee and hip arthroplasties. Arch Orthop Trauma Surg 120:518–520CrossRefPubMed
13.
Zurück zum Zitat Alshryda S, Mason J, Sarda P, Nargol A, Cooke N, Ahmad H, Tang S, Logishetty R, Vaghela M, McPartlin L, Hungin AP (2013) Topical (intra-articular) tranexamic acid reduces blood loss and transfusion rates following total hip replacement: a randomized controlled Trial (TRANX-H). J Bone Joint Surg Am 95:1969–1974 Alshryda S, Mason J, Sarda P, Nargol A, Cooke N, Ahmad H, Tang S, Logishetty R, Vaghela M, McPartlin L, Hungin AP (2013) Topical (intra-articular) tranexamic acid reduces blood loss and transfusion rates following total hip replacement: a randomized controlled Trial (TRANX-H). J Bone Joint Surg Am 95:1969–1974
15.
Zurück zum Zitat Konig G, Hamlin BR, Waters JH (2013) Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty. J Arthroplasty 28:1473–1476CrossRefPubMed Konig G, Hamlin BR, Waters JH (2013) Topical tranexamic acid reduces blood loss and transfusion rates in total hip and total knee arthroplasty. J Arthroplasty 28:1473–1476CrossRefPubMed
16.
Zurück zum Zitat Gross JB (1983) Estimating allowable blood loss: corrected for dilution. Anesthesiology 58:277–280CrossRefPubMed Gross JB (1983) Estimating allowable blood loss: corrected for dilution. Anesthesiology 58:277–280CrossRefPubMed
17.
Zurück zum Zitat Liu X, Zhang X, Chen Y, Wang Q, Jiang Y, Zeng B (2011) Hidden blood loss after total hip arthroplasty. J Arthroplasty 26:1100–1105CrossRefPubMed Liu X, Zhang X, Chen Y, Wang Q, Jiang Y, Zeng B (2011) Hidden blood loss after total hip arthroplasty. J Arthroplasty 26:1100–1105CrossRefPubMed
18.
Zurück zum Zitat Nadler SB, Hidalgo JU, Bloch T (1962) Prediction of blood volume in normal human adults. Surgery 51:224–232PubMed Nadler SB, Hidalgo JU, Bloch T (1962) Prediction of blood volume in normal human adults. Surgery 51:224–232PubMed
19.
Zurück zum Zitat Panteli M, Papakostidis C, Dahabreh Z, Giannoudis P (2013) Topical tranexamic acid in total knee replacement: a systematic review and meta-analysis. Knee 20:300CrossRefPubMed Panteli M, Papakostidis C, Dahabreh Z, Giannoudis P (2013) Topical tranexamic acid in total knee replacement: a systematic review and meta-analysis. Knee 20:300CrossRefPubMed
20.
Zurück zum Zitat Yue C, Kang P, Yang P, Xie J, Pei F (2014) Topical application of tranexamic acid in primary total hip arthroplasty: a randomized double-blind controlled trial. J Arthroplasty 29:2452–2456CrossRefPubMed Yue C, Kang P, Yang P, Xie J, Pei F (2014) Topical application of tranexamic acid in primary total hip arthroplasty: a randomized double-blind controlled trial. J Arthroplasty 29:2452–2456CrossRefPubMed
Metadaten
Titel
Topical administration of tranexamic acid in hip arthroplasty
verfasst von
Joon Soon Kang
Kyoung Ho Moon
Bom Soo Kim
Seong Jo Yang
Publikationsdatum
18.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 2/2017
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-016-3195-2

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