Abstract
Background
Total joint replacement surgery is associated with large amounts of blood loss and significant rates of transfusions. Postoperative bleeding is one of the most important problems after major orthopedic surgeries including revision Total Hip Arthroplasty (THA). It has been demonstrate that Tranexamic acid is a useful agent to control the volume of blood loss. However, the more effective route of TXA administration remained controversial.
Methods
In current study, we compared the effects of local and intravenous(IV) administration of TXA on need to blood transfusion and hemoglobin drop. We randomized 80 patients undergoing revision THA into two groups: local group and IV group. In group IV 40 patients was administrated TXA 4 g alone systemically and in local group 40 patients the joint was irrigated with 4 g of TXA plus 0.33mg DEP (1:200,000).
Results
The level of Hb was measured before and after operation and the rate of Hb drop was compared. Also, the blood transfused were compared in two group. Results showed topical TXA plus DEP substantially reduced total blood loss, hidden blood loss and transfusion rate compared with TXA alone, without increasing the risks of hemodynamic complexity.
Conclusion
We conclude that local use of TXA plus DEP was crucially effective and safe option compared with intravenous TXA alone in reducing total and hidden blood loss and transfusion rate following revision THA without considerable complications.
