This article is more than 5 years old. Information may no longer be current.
Tranexamic acid reduced blood loss, transfusion rates in primary total hip replacement
Fewer transfusions means less risk related to THR surgery, the study authors noted.
Tranexamic acid appears to be effective and safe in reducing blood loss and allogeneic blood transfusion in primary total hip replacement, according to a recently presented study.
The findings were shared by Mohamed Sukeik, MD, at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons in San Diego.
Sukeik said that although allogenic transfusion is safer than ever, it is still associated with risks for the recipient. These risks include allergic reactions, infections and wound complications. As such, his group performed a study to investigate the value of tranexamic acid in reducing blood loss and transfusion after total hip replacement — as well as other clinical outcomes, including deep vein thrombosis, pulmonary embolism, ischemic heart diseases and mortality.
“In this meta-analysis, tranexamic acid significantly reduced intraoperative blood loss and transfusion requirements after primary total hip replacement with no significant increase in complication rates in the study groups,” Sukeik told Orthopaedics Today Europe.
Study parameters
Sukeik’s team performed a systematic review and meta-analysis of published randomized and quasi-randomized trials in which tranexamic acid was used to reduce blood loss during total hip arthroplasty. The researchers evaluated the data through use of the generic evaluation tool designed by the Cochrane Bone, Joint and Muscle Trauma Group.
Sukeik reported 11 clinical trials were considered suitable by his team for detailed data extraction. None of the trials, he said, used tranexamic acid in revision total hip replacement.
Seven studies accounting for 350 patients were eligible to be analyzed for blood loss. Tranexamic acid use in these studies reduced intraoperative blood loss by an average of 104 mL, postoperative blood loss by an average of 172 mL, and total blood loss by an average of 289 mL.
Significant reduction
The group analyzed the outcome of blood transfusion with seven studies — accounting for 346 patients — that fell within proper parameters. Tranexamic acid, the group reported, led to “a significant reduction” in the proportion of patients requiring allogenic blood transfusion.
No significant differences were found between the study groups for length of hospital stay, deep vein thrombosis, pulmonary embolism, mortality, wound hematoma or infections.
“It is certainly a cheap and effective agent which reduces perioperative blood loss and blood transfusion requirements after total hip replacements,” Sukeik said of tranexamic acid, adding it could “provide an alternative to, or at least reduce the need for, blood transfusion with all its associated risks and high costs.”
Future studies
Regarding future studies to further understand tranexamic acid’s potential use, Sukeik told Orthopaedics Today Europe that his group is currently undertaking a randomized controlled trial of topically administered tranexamic acid in hip and knee replacements.
“The aim is to maximize local administration and avoid any possibility of systemic absorption of the medication,” he said. — by Robert Press
Reference:
- Sukeik M, Alshryda A, Haddad FA, Mason J. Systematic review and meta-analysis of the use of antifibrinolytic agents in total hip replacement. Paper #536. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19. San Diego, USA.
- Mohamed Sukeik, MD, can be reached at University College London Hospital, 235 Euston Road, London NW1 2BU, UK; email: msukeik@hotmail.com.
- Disclosure: Sukeik has no relevant financial disclosures.
