The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic?
Obective: The aim of this study was to evaluate the effect of combined intravenous and topical use of tranexamic acid (TXA) on total blood loss and transfusion rate in total hip arthroplasty. Methods: This prospective randomized study included 57 patients who had undergone total hip arthroplasty bet...
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2019-07-01
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| Series: | Acta Orthopaedica et Traumatologica Turcica |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1017995X18304000 |
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| author | Deniz Gulabi Yucel Yuce Kutlu Hakan Erkal Necdet Saglam Savas Camur |
| author_facet | Deniz Gulabi Yucel Yuce Kutlu Hakan Erkal Necdet Saglam Savas Camur |
| author_sort | Deniz Gulabi |
| collection | DOAJ |
| description | Obective: The aim of this study was to evaluate the effect of combined intravenous and topical use of tranexamic acid (TXA) on total blood loss and transfusion rate in total hip arthroplasty. Methods: This prospective randomized study included 57 patients who had undergone total hip arthroplasty between September 2016 and September 2017. The IV administration group (Group 1) consisted of 26 patients (mean age: 63.73 ± 10.29 years), while the IV and topical administiration group (Group 2) consisted of 22 patients (62.82 ± 8.31 years). Demographic data and outcomes were obtained through a review of individual medical records. Medical comorbidities, body mass index (BMI), ASA and CCI, preoperative and postoperative hemoglobin levels, postoperative transfusion records and 90-day joint-related (implant subsidence, dislocation, postoperative anemia, deep infection, hematoma and/or wound problem, postoperative periprosthetic fracture) readmission rate and complication rate were compared between the groups. Results: No significant differences were observed between the 2 groups in terms of age, gender, height, weight, body mass index (BMI), the level of preoperative Hb values, and the American Society of Anesthesiologists (ASA) and Charleson Comorbidty Index (CCI) rating (p > 0.05). The mean postoperative Hgb in the group 2 was higher by a small amount compared to the group 1. No statistically significant difference was determined between the groups in respect of the Hgb values (p = 0.562). Hgb Delta in the group 2 was lower than that of the group 1. The difference between the groups in the Hgb Delta values was not statistically significant (p = 0.268). The mean total blood loss was lower in the group 2 than in the group 1 but the difference was not statistically significant (p = 0.788). There was no significant difference observed in terms of any adverse complications among the 2 groups (p > 0.05). Conclusion: The combined administration of IV and topical TXA compared with IV alone can decrease total blood loss and the number of blood transfusions required without increasing the risk of DVT or/and PE in total hip arthroplasty. But the statistical analysis and clinical relevance is not significant. Level of Evidence: Level I Therapeutic Study. Keywords: Hip arthroplasty, Blood loss, Hgb, TXA, DVT |
| format | Article |
| id | doaj-art-c9d76017e7ff4a18a901dff1ebe6e1e7 |
| institution | Kabale University |
| issn | 1017-995X |
| language | English |
| publishDate | 2019-07-01 |
| publisher | AVES |
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| series | Acta Orthopaedica et Traumatologica Turcica |
| spelling | doaj-art-c9d76017e7ff4a18a901dff1ebe6e1e72025-08-20T03:38:49ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2019-07-0153429730010.1016/j.aott.2019.03.001The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic?Deniz Gulabi0Yucel Yuce1Kutlu Hakan Erkal2Necdet Saglam3Savas Camur4Bahcesehir University, Faculty of Medicine, Orthopaedic and Traumatology Department, İstanbul, Turkey; Corresponding author. VM Medicalpark Pendik Hospital, Fevzi cakmak Mah. Eski karakol sok. No: 934899, Pendik, Istanbul, 34899, Turkey. Tel.:+90216 2754000/90 532 3654768; fax: +90216 2754990.Saglik Bilimleri University, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, TurkeySaglik Bilimleri University, Kartal Dr. Lütfi Kırdar Training and Research Hospital, İstanbul, TurkeySaglik Bilimleri University, Umraniy Training and Research Hospital, Istanbul, TurkeySaglik Bilimleri University, Umraniy Training and Research Hospital, Istanbul, TurkeyObective: The aim of this study was to evaluate the effect of combined intravenous and topical use of tranexamic acid (TXA) on total blood loss and transfusion rate in total hip arthroplasty. Methods: This prospective randomized study included 57 patients who had undergone total hip arthroplasty between September 2016 and September 2017. The IV administration group (Group 1) consisted of 26 patients (mean age: 63.73 ± 10.29 years), while the IV and topical administiration group (Group 2) consisted of 22 patients (62.82 ± 8.31 years). Demographic data and outcomes were obtained through a review of individual medical records. Medical comorbidities, body mass index (BMI), ASA and CCI, preoperative and postoperative hemoglobin levels, postoperative transfusion records and 90-day joint-related (implant subsidence, dislocation, postoperative anemia, deep infection, hematoma and/or wound problem, postoperative periprosthetic fracture) readmission rate and complication rate were compared between the groups. Results: No significant differences were observed between the 2 groups in terms of age, gender, height, weight, body mass index (BMI), the level of preoperative Hb values, and the American Society of Anesthesiologists (ASA) and Charleson Comorbidty Index (CCI) rating (p > 0.05). The mean postoperative Hgb in the group 2 was higher by a small amount compared to the group 1. No statistically significant difference was determined between the groups in respect of the Hgb values (p = 0.562). Hgb Delta in the group 2 was lower than that of the group 1. The difference between the groups in the Hgb Delta values was not statistically significant (p = 0.268). The mean total blood loss was lower in the group 2 than in the group 1 but the difference was not statistically significant (p = 0.788). There was no significant difference observed in terms of any adverse complications among the 2 groups (p > 0.05). Conclusion: The combined administration of IV and topical TXA compared with IV alone can decrease total blood loss and the number of blood transfusions required without increasing the risk of DVT or/and PE in total hip arthroplasty. But the statistical analysis and clinical relevance is not significant. Level of Evidence: Level I Therapeutic Study. Keywords: Hip arthroplasty, Blood loss, Hgb, TXA, DVThttp://www.sciencedirect.com/science/article/pii/S1017995X18304000 |
| spellingShingle | Deniz Gulabi Yucel Yuce Kutlu Hakan Erkal Necdet Saglam Savas Camur The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic? Acta Orthopaedica et Traumatologica Turcica |
| title | The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic? |
| title_full | The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic? |
| title_fullStr | The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic? |
| title_full_unstemmed | The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic? |
| title_short | The combined administration of systemic and topical tranexamic acid for total hip arthroplasty: Is it better than systemic? |
| title_sort | combined administration of systemic and topical tranexamic acid for total hip arthroplasty is it better than systemic |
| url | http://www.sciencedirect.com/science/article/pii/S1017995X18304000 |
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