The Use of Tranexamic Acid in Orthopaedic Surgery

Abstract

New surgical techniques (minimally invasive surgery – (MIS), laparoscopic surgery), meticulous consideration of haemostasis, use of robots, Cell Saver and tranexamic acid, new transfusion criteria and single red blood cell (RBC) unit ordering have greatly changed clinical practices. Implementation of these therapeutic options along with other practices has significantly contributed to the effectiveness of the patient blood management approach to surgical patients. In recent years use of anti-fibrinolytic agent tranexamic acid (TXA) has been introduced at our department and intravenous administration as well as topical TXA administration were successfully implemented. Use of topical TXA was effective at reducing both post-operative red blood cell loss and transfusion rates with good tolerance and no clinically relevant adverse events. Within 6 years of Patient Blood Management (PBM) protocol implementation in our institution, the total number of transfusions was reduced by 76 % and the percentage of patients requiring transfusion fell from 38 % to 9 %. Keywords: Tranexamic acid; Blood loss; Orthopaedic surgery; Endoprosthesis; Joint arthroplasty