Ying Zhang1,2, Leilei Zhang1,2, Xianghao Ma1,2, Yudong Jia1,2, Huichao Wang1,2, Yingjie Zhu1,2, Youwen Liu3,4. 1. Medical Center of Hip, Luoyang Orthopedic Traumatology Hospital, No. 82, South Qiming Road, 471002, Henan, China. 2. Orthopedics Hospital of Henan Province, Luoyang, China. 3. Medical Center of Hip, Luoyang Orthopedic Traumatology Hospital, No. 82, South Qiming Road, 471002, Henan, China. liuyouwenzhenggu@sina.com. 4. Orthopedics Hospital of Henan Province, Luoyang, China. liuyouwenzhenggu@sina.com.
Abstract
PURPOSE: In the total hip arthroplasty (THA), the optimal administration route of tranexamic acid (TXA) remains controversial. This study was designed to investigate the impact of topical injection of TXA on blood loss during primary unilateral THA as well as short-term safety and adverse side effects compared with intravenous administration of TXA. MATERIAL AND METHODS: In this study, 75 patients who underwent unilateral THA were randomly divided into 3 groups receiving intra-articular TXA (IA group), intravenous TXA (IV group) or no TXA (control group C). Blood loss, postoperative drainage, covert blood loss, total blood volume, the number of blood transfusions after surgery and transfusion rate, incidence of deep venous thrombosis and pulmonary embolism were recorded and evaluated in the three groups after 1 week and 1 month. RESULTS: There were significant differences in the quantity of postoperative drainage, covert blood loss, total blood volume, the number of blood transfusions after surgery and transfusion rates between the three groups (P < 0.05), but blood loss during surgery showed no significant differences among the three groups (P > 0.05). In the IV group, 1 patient suffered from deep venous thrombosis of the lower limbs and in the C group, 2 patients suffered from superficial venous thrombosis of the lower limbs 2 and 4 days after surgery, respectively. In the IA group no complications occurred during the follow-up period. CONCLUSION: Preoperative intravenous TXA and postoperative topical TXA significantly reduced postoperative blood loss and transfusion rates among the patients who underwent primary unilateral THA and the short-term safety was good. The data suggest that topical injection of TXA is safer and more effective, without postoperative complications.
RCT Entities:
PURPOSE: In the total hip arthroplasty (THA), the optimal administration route of tranexamic acid (TXA) remains controversial. This study was designed to investigate the impact of topical injection of TXA on blood loss during primary unilateral THA as well as short-term safety and adverse side effects compared with intravenous administration of TXA. MATERIAL AND METHODS: In this study, 75 patients who underwent unilateral THA were randomly divided into 3 groups receiving intra-articular TXA (IA group), intravenous TXA (IV group) or no TXA (control group C). Blood loss, postoperative drainage, covert blood loss, total blood volume, the number of blood transfusions after surgery and transfusion rate, incidence of deep venous thrombosis and pulmonary embolism were recorded and evaluated in the three groups after 1 week and 1 month. RESULTS: There were significant differences in the quantity of postoperative drainage, covert blood loss, total blood volume, the number of blood transfusions after surgery and transfusion rates between the three groups (P < 0.05), but blood loss during surgery showed no significant differences among the three groups (P > 0.05). In the IV group, 1 patient suffered from deep venous thrombosis of the lower limbs and in the C group, 2 patients suffered from superficial venous thrombosis of the lower limbs 2 and 4 days after surgery, respectively. In the IA group no complications occurred during the follow-up period. CONCLUSION: Preoperative intravenous TXA and postoperative topical TXA significantly reduced postoperative blood loss and transfusion rates among the patients who underwent primary unilateral THA and the short-term safety was good. The data suggest that topical injection of TXA is safer and more effective, without postoperative complications.
Entities:
Keywords:
Adverse effects; Orthopedics; Osteonecrosis of the femoral head; Randomized controlled study; Safety
Authors: Sheraz R Markar; Gareth G Jones; Alan Karthikesalingam; Nicholas Segaren; Rahul V Patel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-11-10 Impact factor: 4.342
Authors: Sattar Alshryda; James Mason; Praveen Sarda; Antoni Nargol; Nick Cooke; Hafeez Ahmad; S Tang; Raj Logishetty; Manesh Vaghela; Lynne McPartlin; A Pali S Hungin Journal: J Bone Joint Surg Am Date: 2013-11-06 Impact factor: 5.284
Authors: Scott M Bolam; Arama O'Regan-Brown; A Paul Monk; David S Musson; Jillian Cornish; Jacob T Munro Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-08-29 Impact factor: 4.342