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Matched cohort study of topical tranexamic acid in cementless primary total hip replacement

  • Original Article • HIP - ARTHROPLASTY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid.

Methods

This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events.

Results

We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P < 0.001). The mean total blood loss was 769 in topical tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase.

Conclusions

A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group.

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Authors and Affiliations

  1. Hip Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Av de Denia 76, 03016, Alicante, Spain

    Javier Sanz-Reig, Jesus Mas Martinez, Carmen Verdu Román, Manuel Morales Santias, Enrique Martínez Gimenez & David Bustamante Suarez de Puga

Authors
  1. Javier Sanz-Reig
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  2. Jesus Mas Martinez
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  3. Carmen Verdu Román
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  4. Manuel Morales Santias
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  5. Enrique Martínez Gimenez
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  6. David Bustamante Suarez de Puga
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Correspondence to Javier Sanz-Reig.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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IRB approval and informed consent were obtained.

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Sanz-Reig, J., Mas Martinez, J., Verdu Román, C. et al. Matched cohort study of topical tranexamic acid in cementless primary total hip replacement. Eur J Orthop Surg Traumatol 28, 1335–1339 (2018). https://doi.org/10.1007/s00590-018-2192-0

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  • DOI: https://doi.org/10.1007/s00590-018-2192-0

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