Effect of local application of tranexamic acid without drainage on blood loss in elderly patients with hip hemiarthroplasty

Abstract

Objective To explore the effect of local application of tranexamic acid (TXA) without drainage on blood loss in elderly patients with hip hemiarthroplasty. Methods A retrospective study was performed in 50 elderly cases of femoral neck fractures who had underwent hip hemiarthroplasty in department of Bone and Joint Surgery of Affiliated Hospital of Jining Medical University. Patients were randomly divided into the TXA group (n=25) and the control group (n=25). The TXA group received the intra-articular injection of 2 g TXA dissolved in 50 ml of normal saline, the control group received the intra-articular injection of the same volume of normal saline before closing the incision. The drainage tube was not used in both groups. The intraoperative blood loss, external blood loss, hidden blood loss, total blood loss, transfusion rate, postoperative hemoglobin concentration and complications were compared between the two groups. Results The postoperative hemoglobin concentrations in the TXA group were higher than those in the control group (t=7.473, t=7.226, t=7.572, P 0.05). Conclusion Local application of tranexamic acid (TXA) without drainage can effectively reduce perioperative blood loss and transfusion rate, and does not increase the incidence of complications in the elderly patients with hip hemiarthroplasty. Key words: Femoral neck fractures; Arthroplasty, replacement, hip; Tranexamic acid; Blood loss, sugical; Venous thrombosis