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- Title
Effectiveness of different doses and routes of administration of tranexamic acid for total hip replacement.
- Authors
Palija, Stanislav; Bijeljac, Sinisa; Manojlovic, Slavko; Jovicic, Zeljko; Jovanovic, Milan; Cvijic, Petar; Dragicevic-Cvjetkovic, Dragana
- Abstract
<bold>Purpose: </bold>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).<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
TOTAL hip replacement; TRANEXAMIC acid; AUTOTRANSFUSION of blood; BLOOD transfusion; COST effectiveness; TREATMENT effectiveness; SURGICAL blood loss; RESEARCH; RESEARCH methodology; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; ANTIFIBRINOLYTIC agents; CUTANEOUS therapeutics; LONGITUDINAL method
- Publication
International Orthopaedics, 2021, Vol 45, Issue 4, p865
- ISSN
0341-2695
- Publication type
journal article
- DOI
10.1007/s00264-020-04585-y