Topical vs Intravenous Tranexamic Acid in Primary Total Hip Arthroplasty: A Double-Blind, Randomized Controlled Trial.
North WT, Mehran N, Davis JJ, Silverton CD, Weir RM, and Laker MW. Topical vs intravenous tranexamic acid in primary total hip arthroplasty: A double-blind, randomized controlled trial. J Arthroplasty 2015; 31(5):1022-1026
The Journal of arthroplasty
BACKGROUND: Tranexamic acid (TXA) reduces perioperative blood loss in total hip arthroplasty (THA).
METHODS: In our randomized control trial, 139 patients were enrolled and received 2 g of either topical or intravenous (IV) TXA. Preoperative and postoperative protocols were standardized.
RESULTS: Calculated blood and Hgb loss were lower in the IV group (1195.0 ± 485.9 mL, 1442.7 ± 562.7 mL; P = .006), (160.3 [g] ± 63.8, 188.4 [g] ± 68.5; P = .014). There was a trend toward significance in transfusion reduction (11% [IV] vs 18% [topical]; P = .3). Both groups effectively reduced the transfusion rate. There was significant financial incentive for the use of TXA in THA with a savings of $314 per patient.
CONCLUSIONS: IV and topical TXA are effective tools to reduce blood loss and transfusion costs in THA, and we recommend the IV form for ease of use.
Medical Subject Headings
Administration, Intravenous; Administration, Topical; Aged; Antifibrinolytic Agents; Arthroplasty, Replacement, Hip; Blood Loss, Surgical; Blood Transfusion; Double-Blind Method; Female; Humans; Male; Middle Aged; Postoperative Hemorrhage; Prospective Studies; Tranexamic Acid