Tranexamic acid may reduce blood loss, transfusion rates after hemiarthroplasty, THA
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Key takeaways:
- Tranexamic acid yielded a lower decrease in hemoglobin after total hip arthroplasty and hemiarthroplasty.
- Patients who received tranexamic acid during total hip arthroplasty had lower transfusion rates.
LAS VEGAS — Results showed tranexamic acid may reduce blood loss and transfusion requirements postoperatively among patients who underwent hemiarthroplasty or total hip arthroplasty for pathologic hip fractures.
“This is prospective data that’s the first to our knowledge to support the use of [tranexamic acid] TXA in patients who receive these common procedures or are treated for pathologic fractures,” Caleb Yeung, MD, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.
Yeung and colleagues assessed the decrease in hemoglobin from pre-surgical values to postoperative Day 1, transfusion requirement, and rate of venous thromboembolism and mortality events with a minimum follow-up of 90 days among 37 patients who underwent either hip hemiarthroplasty (n=18) or THA (n=19) for a pathologic hip fracture for metastatic disease. For both procedure groups, researchers compared patients who received 1,000 mg of TXA intravenously at the time of incision to patients who did not receive TXA and were matched by gender, primary malignancy, preoperative hemoglobin and age.
Among patients who underwent THA, Yeung noted patients who received TXA had a lower decrease in postoperative hemoglobin compared with patients who did not receive TXA. Researchers also found patients who received TXA had a significantly lower transfusion requirement.
“There were no [deep vein thromboembolic or pulmonary embolic] DVT or PE events in the TXA group vs. one in the control group, although this was not statistically significant, and no incidences of mortality at 90 days,” Yeung said.
Yeung noted similar findings among patients who underwent hip hemiarthroplasty, with a lower postoperative decrease in hemoglobin among patients who received TXA. He added no patients in the TXA group received a transfusion vs. an average of 0.2 units transfused in the control group, which trended toward significance.
“Importantly, again, no DVT or PE events in the TXA group vs. one in the control group and this was not statistically different in comparison,” Yeung said. “Again, no instances of mortality at 90 days for either of these groups.”
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Yeung C, et al. Paper 400. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. March 7-11, 2023; Las Vegas.
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