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Findings support efficacy, cost-effectiveness of TXA vs reinfusion drains for TJA
Results from this prospective, randomized study showed use of tranexamic acid for total joint arthroplasty led to a significantly lower drop in hemoglobin levels compared with the use of standard and reinfusion drains, and the cost associated with tranexamic acid was less than that of reinfusion drains.
Researchers randomized 186 patients who underwent primary total joint arthroplasty (TJA) to receive either standard drains, autologous reinfusion drains or a single dose of tranexamic acid (TXA). Patients intraoperatively received hemostasis with electrocautery before wound closure. The primary outcomes for this study were the rate of allogeneic blood transfusion, change in hemoglobin level, the amount of autologous blood reinfusion and hospital costs.
Results showed the TXA group had a significantly lower drop in hemoglobin level compared with the standard drain group and reinfusion group. The standard drains and reinfusion drains had similar median hemoglobin levels.
Groups were not statistically different with regard to the transfusion rate. Mean hemoglobin level was not significantly different between patients who received a blood transfusion compared with patients who did not have a blood transfusion. According to researchers, the reinfusion system cost was $581.89 per use, which was substantially higher than that for TXA and the standard drains, $35.91/g and $7.56, respectively. ‒ by Monica Jaramillo
Disclosures: Springer reports is a paid consultant for Convatec, Polaris and Stryker; is a paid presenter or speaker for Depuy, A Johnson & Johnson Company, and Cermatec; and receives other financial or material support from Joint Purification Systems. Please see the full study for a list of all other authors’ relevant financial disclosures.