Stanislav Palija1, Sinisa Bijeljac2, Slavko Manojlovic3, Zeljko Jovicic2, Milan Jovanovic2, Petar Cvijic2, Dragana Dragicevic-Cvjetkovic2. 1. Orthopedic Department, Institute for Physical Medicine and Rehabilitation "Dr Miroslav Zotovic", Slatinska 11, 78000, Banja Luka, Bosnia and Herzegovina. stanislav.palija@gmail.com. 2. Orthopedic Department, Institute for Physical Medicine and Rehabilitation "Dr Miroslav Zotovic", Slatinska 11, 78000, Banja Luka, Bosnia and Herzegovina. 3. Medical Faculty, Department of Surgery, University of Banja Luka, Banja Luka, Bosnia and Herzegovina.
Abstract
PURPOSE: The aim of the study is to show the therapeutic efficacy, safety, and cost-benefit of using tranexamic acid (TXA), as well as the superiority of the route of administration and amount of dose in primary cementless total hip replacement (THR). METHODS: In this prospective, randomized, double-blind study, we divided 200 patients into five groups of 40 patients each. The placebo group did not receive TXA. Three groups received 2 g TXA each (intravenous, topical, and combined intravenous + topical), while the fifth, combined + group, received 4 g TXA. Total blood loss was calculated, number of transfusions and thromboembolic vascular incidents were monitored, and a cost-benefit analysis of the use of TXA was performed. RESULTS: Regardless of the route of administration, TXA statistically significantly reduced total blood loss (p = 0.000) and the need for transfusion (p = 0.000) compared with placebo. Total blood loss and the need for allogenic blood transfusion were statistically significantly reduced in the combined + group compared with placebo, and also compared with all other groups. Post-operative thromboembolic vascular incidents were not reported. The cost-benefit of using TXA in THR is associated with reduction of transfusion costs. CONCLUSIONS: None of the TXA administration routes are superior to others, but multiple doses could statistically significantly reduce blood loss and transfusion requirements, which should be the subject of future researches.
RCT Entities:
PURPOSE: The aim of the study is to show the therapeutic efficacy, safety, and cost-benefit of using tranexamic acid (TXA), as well as the superiority of the route of administration and amount of dose in primary cementless total hip replacement (THR). METHODS: In this prospective, randomized, double-blind study, we divided 200 patients into five groups of 40 patients each. The placebo group did not receive TXA. Three groups received 2 g TXA each (intravenous, topical, and combined intravenous + topical), while the fifth, combined + group, received 4 g TXA. Total blood loss was calculated, number of transfusions and thromboembolic vascular incidents were monitored, and a cost-benefit analysis of the use of TXA was performed. RESULTS: Regardless of the route of administration, TXA statistically significantly reduced total blood loss (p = 0.000) and the need for transfusion (p = 0.000) compared with placebo. Total blood loss and the need for allogenic blood transfusion were statistically significantly reduced in the combined + group compared with placebo, and also compared with all other groups. Post-operative thromboembolic vascular incidents were not reported. The cost-benefit of using TXA in THR is associated with reduction of transfusion costs. CONCLUSIONS: None of the TXA administration routes are superior to others, but multiple doses could statistically significantly reduce blood loss and transfusion requirements, which should be the subject of future researches.
Entities:
Keywords:
Total blood loss; Total hip replacement; Tranexamic acid; Transfusion
Authors: A Merchán-Galvis; M Posso; E Canovas; M Jordán; X Aguilera; M J Martinez-Zapata Journal: BMC Musculoskelet Disord Date: 2022-08-31 Impact factor: 2.562