ABSTRACT
INTRODUCTION: Tranexamic acid (TXA) is an antifibrinolytic agent that competitively inhibits the activation of plasminogen to plasmin. It has been shown to reduce blood loss in trauma and other haemorrhagic conditions and has recently been utilised in elective orthopaedic surgery. There are various methods of administering TXA described in the literature. METHODS: This retrospective cohort study reviews the effects of a single perioperative 1 g intravenous bolus on patients undergoing primary hip and knee arthroplasty and its effect on operative blood loss. After excluding patients who did not fulfil our inclusion criteria, a total of 110 patients were included in this study. Fifty underwent primary hip arthroplasty (30 treated with TXA; 60.0 %), and 60 underwent primary knee arthroplasty (29 treated with TXA; 48.3 %). The main outcome measure was red cell volume and total blood loss, and secondary measures were needed for blood transfusions, presence of thromboembolic events, and length of hospital stay. RESULTS: Both cohorts who received TXA showed a reduction in immediate postoperative red cell volume loss and total blood loss (p < 0.01). There was no association with the administration of TXA and the rate of postoperative blood transfusions (hip p = 0.36, knee p = 0.13), incidence of symptomatic deep vein thrombosis (hip p = 0.36, knee p = 0.31), or postoperative hospital length of stay (hip p = 0.70, knee p = 0.68). CONCLUSION: This study demonstrates that a single perioperative bolus of intravenous TXA may significantly reduce operative blood loss in both primary total hip and knee arthroplasty in a cost-effective manner, in combination with meticulous perioperative haemostasis.
Subject(s)
Antifibrinolytic Agents/administration & dosage , Arthroplasty, Replacement, Hip/methods , Arthroplasty, Replacement, Knee/methods , Blood Loss, Surgical/prevention & control , Tranexamic Acid/administration & dosage , Adult , Aged , Aged, 80 and over , Antifibrinolytic Agents/adverse effects , Arthroplasty, Replacement, Hip/adverse effects , Arthroplasty, Replacement, Knee/adverse effects , Blood Transfusion , Blood Volume , Erythrocyte Volume/drug effects , Female , Humans , Injections, Intravenous , Length of Stay , Male , Middle Aged , Perioperative Care , Retrospective Studies , Tranexamic Acid/adverse effects , Venous Thrombosis/chemically inducedABSTRACT
The purpose of the study was to assess whether patients who undergo hip resurfacing arthroplasty are able to take part in sporting activity following surgery. Sporting activity before and after surgery was assessed by means of a questionnaire in 43 patients who underwent a total of 51 hip resurfacing procedures. Thirty-three hips (65 %) participated in sports before surgery. This increased to 47 (92 %) following surgery. Fourteen out of the 18 hips (78 %) that did not participate in sports before surgery went on to take part in at least one sport following surgery. There were also significant increases in intensity and frequency of sports participation following surgery. In conclusion, patients who participate in sports before surgery are able to return to sports following the procedure. Furthermore a significant proportion of patients who did not do any sports before surgery are able to take part in sports after surgery.
