Abstract
Purpose
Transfusion rates after primary total hip has been reported up to 39.2%. The purpose of our study was to evaluate the efficacy of TXA in minimizing risk of allogeneic blood transfusion after primary total hip and hip resurfacing arthroplasty.
Method
Retrospective data on a cohort of 88 patients undergoing total hip arthroplasty and 44 who undergoing hip resurfacing arthroplasty who received a single pre-operative bolus of 1g TXA was compared with a control group matched for starting haemoglobin (Hg), body mass index (BMI), age, gender, blood loss, surgical time, and surgeon. All procedures were completed at a single institution with standardized post-operative care. Endpoints included allogeneic blood transfusion rate, post operative day one Hg, and overall Hg decrease.
Results
Transfusion rate among the total hip TXA group was 5.7% and among control patients 22.7% (p=0.001). Transfusion rates among resurfacing patients showed no statistical difference between the treatment group and matched controls. Mean overall haemoglobin decrease was found to be significantly lower in the TXA treatment groups for both total hip and hip resurfacing arthroplasty (p<0.0001 and p=0.01 respectively). Patients who received TXA and allogeneic blood transfusion were found to have a significantly lower pre-operative Hg versus transfusion negative TXA treated patients (113.7 g/dL and 141.5 g/dL respectively).
Conclusion
We have shown TXA use in primary total hip arthroplasty significantly decreases allogeneic blood transfusion rate. TXA use in hip resurfacing arthroplasty failed to show significant difference in transfusion rate yet calculated blood loss was less. Patients presenting with low pre-operative Hb remain high risk for allogeneic blood transfusion despite TXA treatment.
