Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Oct;14(5):544-550.
doi: 10.1177/17585732211023053. Epub 2021 Jul 26.

Impact of tranexamic acid on clinical and hematologic outcomes following total shoulder arthroplasty

McKayla Kelly  1 , Justin Turcotte  1 , M Brook Fowler  1 , Michaline West  1 , Cyrus Lashgari  1 , Jeffrey Gelfand  1
Affiliations

Impact of tranexamic acid on clinical and hematologic outcomes following total shoulder arthroplasty

McKayla Kelly et al. Shoulder Elbow. 2022 Oct.

Abstract

Background: The purpose of this study is to evaluate the impact of intravenous tranexamic acid on clinical and hematologic outcomes after total shoulder arthroplasty.

Methods: Retrospective review was conducted for 282 consecutive patients undergoing either anatomic shoulder arthroplasty or reverse total shoulder arthroplasty. Univariate analysis and multivariate linear regression were used to compare outcomes for patients receiving intravenous tranexamic acid with those who did not.

Results: Of the 282 patients included in this study, 78 patients received intravenous tranexamic acid and 204 did not. Patients who received intravenous tranexamic acid had significantly lower pre- to postoperative change in hemoglobin and hematocrit, and decreased postoperative drain output. In addition, patients receiving intravenous tranexamic acid were significantly less likely to have a postoperative hematocrit <30. There were no significant differences in length of stay, rate of 30 day hematoma, surgical site infection, deep vein thrombosis, or readmission between groups.

Conclusion: Intravenous tranexamic acid is associated with a significant reduction in change in hematocrit and hemoglobin and postoperative drain output after both anatomic and reverse total shoulder arthroplasty. Despite improving hematologic outcomes for these patients, tranexamic acid appears to have little impact on clinical outcomes such as length of stay and 30-day complication rates.

Keywords: Tranexamic acid; blood loss; complications; length of stay; reverse shoulder arthroplasty; total shoulder arthroplasty.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. Kim SH, Wise BL, Zhang Y, et al. Increasing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am 2011; 93: 2249–2254. - PubMed
    1. Wagner ER, Farley KX, Higgins I, et al. The incidence of shoulder arthroplasty: rise and future projections compared with hip and knee arthroplasty. J Shoulder Elbow Surg 2020; 29: 2601–2609. - PubMed
    1. Norris TR, Iannotti JP. Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. J Shoulder Elbow Surg 2002; 11: 130–135. - PubMed
    1. Ahmadi S, Lawrence TM, Sahota S, et al. The incidence and risk factors for blood transfusion in revision shoulder arthroplasty: our institution's experience and review of the literature. J Shoulder Elbow Surg 2014; 23: 43–48. - PubMed
    1. Gruson KI, Accousti KJ, Parsons BO, et al. Transfusion after shoulder arthroplasty: an analysis of rates and risk factors. J Shoulder Elbow Surg 2009; 18: 225–230. - PubMed

LinkOut - more resources