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Randomized Controlled Trial
. 2021 Apr;45(4):865-870.
doi: 10.1007/s00264-020-04585-y. Epub 2020 May 6.

Effectiveness of different doses and routes of administration of tranexamic acid for total hip replacement

Stanislav Palija  1 , Sinisa Bijeljac  2 , Slavko Manojlovic  3 , Zeljko Jovicic  2 , Milan Jovanovic  2 , Petar Cvijic  2 , Dragana Dragicevic-Cvjetkovic  2
Affiliations
Randomized Controlled Trial

Effectiveness of different doses and routes of administration of tranexamic acid for total hip replacement

Stanislav Palija et al. Int Orthop. 2021 Apr.

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.

Keywords: Total blood loss; Total hip replacement; Tranexamic acid; Transfusion.

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References

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