The role of intravenous tranexamic acid for blood loss in total hip arthroplasty secondary to femoral neck fracture

Abstract

Aim: The aim of the study was to compare the efficacy of intravenous (IV) administration of tranexamic acid (TXA) in terms of bleeding volume, allogeneic blood transfusion (ABT) requirement, and complications in total hip arthroplasty (THA) secondary to osteoporotic femoral neck fracture (FNF).
 Material and Method: A total of 165 patients who underwent THA on the background of FNF in our clinic were included in the study. Patients' demographic data, preoperative and postoperative blood parameters, the amount of blood loss calculated according to the Nadler formula, amount of ABT, and complications at the 90-day follow-up were recorded. The patients were divided into two groups those who received 15mg/kg preoperatively and 10mg/kg IV TXA at the end of the operation (TXA group-89 patients) and those who did not receive TXA (Control group-76 patients) and the two groups were compared.
 Results: The total amount of bleeding calculated according to the Nadler formula was significantly less in the TXA group (1659,68±320,86ml) compared with the Control group (1774,43±365,24ml) (p=0.033). The need for ABT was 42.86% in the TXA group and 57.14% in the control group, and this difference was statistically significant (p=0.008).
 Conclusion: In patients who underwent THA on the basis of osteoporotic FNF, preoperative and postoperative administration of 2 doses of IV TXA significantly reduced total blood loss and the need for ABT. We suggest that IV TXA administration can be safely performed, especially in this patient group, to reduce the amount of bleeding and therefore the need for ABT by not increasing any thromboembolic complications.