ABSTRACT
PURPOSE: The purpose of this study was to assess the efficacy of a newly designed topical administration of tranexamic acid (TXA) in reducing post-operative bleeding in total hip arthroplasty (THA) and bipolar hip hemiarthroplasty (BHA). METHODS: A consecutive series of 160 patients who underwent hip arthroplasty was enrolled in this study. Topical administration of TXA was done in group 1 (40 patients underwent THA and 40 BHA). We compared the amount of blood loss and rates of post-operative transfusion in group 1 with those of group 2 (40 cases of THA and 40 cases of BHA) in which TXA solution was not applied. RESULTS: The total amount of blood loss in THA group 1 and THA group 2 was 793 ± 50 mL and 1086 ± 73 mL, respectively (p = 0.001). The transfusion rates of THA group 1 and THA group 2 was 27.5 % and 50 %, respectively (p = 0.039). The transfusion rates of BHA group 1 and BHA group 2 was 45 % and 60 %, respectively (p = 0.179). The amounts of blood loss through the drainage tube were 186 ± 22 mL and 257 ± 24 mL in THA group 1 and THA group 2, respectively, and 101 ± 11 mL and 147 ± 16 mL in BHA group 1 and BHA group 2, respectively, showing statistical significance. No complications such as infection, deep vein thrombosis or cardiovascular disease were observed during the hospital stay and the last follow-up. CONCLUSION: Topical administration of TXA is an effective and safe method to reduce post-operative bleeding and transfusion rates in hip arthroplasty.
Subject(s)
Antifibrinolytic Agents/administration & dosage , Arthroplasty, Replacement, Hip/methods , Postoperative Hemorrhage/prevention & control , Tranexamic Acid/administration & dosage , Administration, Topical , Aged , Aged, 80 and over , Arthroplasty, Replacement, Hip/adverse effects , Blood Transfusion/statistics & numerical data , Female , Humans , Male , Middle Aged , Postoperative Hemorrhage/epidemiology , Postoperative Hemorrhage/etiologyABSTRACT
PURPOSE: The results of ceramic-on-ceramic (CoC) bearing surfaces in primary total hip arthroplasty (THA) were well known. However, it was not known in revision THA. The purpose of this study is to report the results of revision THA with ceramic articulation. MATERIALS AND METHODS: A total of 112 revision THAs were evaluated. The mean age at the time of surgery was 51.6 years (27.7 to 84.2 years). The mean duration of the follow-up periods was 6.3 years (2.3 to 11.4 years). RESULTS: The Harris hip scores improved from an average of 56.2 at the index surgery to an average of 93.3 at the last follow-up (P<0.001). None of hips showed osteolysis or ceramic head fracture. One hip showed aseptic loosening in the acetabular component with squeaking that caused a re-revision. There were nine cases of dislocation. The survivorship at 5 years was 94.5% (95% confidence interval, 87.9% to 97.6%) with revision for any reason as the endpoint and 100% with femoral revision. CONCLUSION: The ceramic articulation is one of good bearing options for revision THA in patients with a long life expectancy.
