Tranexamic acid (TXA), an inhibitor of fibrinolysis,
reduces blood loss after total knee arthroplasty. However, its effect
on minimally invasive total hip arthroplasty (THA) is not clear.
We performed a prospective, randomised double-blind study to evaluate
the effect of two intravenous injections of TXA on blood loss in
patients undergoing minimally invasive THA. In total, 60 patients (35 women and 25 men with a mean age of
58.1 years; 17 to 84) who underwent unilateral minimally invasive
uncemented THA were randomly divided into the study group (30 patients,
20 women and ten men with a mean age of 56.5 years; 17 to 79) that
received two intravenous injections 1 g of TXA pre- and post-operatively
(TXA group), and a placebo group (30 patients, 15 women and 15 men
with a mean age of 59.5 years; 23 to 84). We compared the peri-operative
blood loss of the two groups. Actual blood loss was calculated from
the maximum reduction in the level of haemoglobin. All patients
were followed clinically for the presence of venous thromboembolism. The TXA group had a lower mean intra-operative blood loss of
441 ml (150 to 800) This prospective, randomised controlled study showed that a regimen
of two intravenous injections of 1 g TXA is effective for blood
conservation after minimally invasive THA. Cite this article:
Introduction: The potential benefits of
Introduction:
In recent years advances in operative techniques have allowed surgeons to perform total hip arthroplasty (THA) through incisions much smaller than those used previously. Potential advantages of these techniques include the reduction of blood loss and pain in the immediate postoperative period and preserving muscle function. Potential disadvantages might include increased wound infection rate due to skin ischemia, intraoperative neurovascular injuries, and component malposition. This in turn may lead to long term complications, such as instability, osteolysis, and loosening. The purpose of this study is to present our results with total hip arthroplasty performed through a minimal invasive technique which is a modification of the standard posterolateral approach. Methods: In this retrospective study 91 consecutive patients underwent primary total hip arthroplasties were reviewed. The surgeries were performed at our institution from January 2001 to December 2003. Surgical indications included primary osteoarthritis, subcapital fractures, malignancy, hip displasia, Otopelvis, rheumatoid arthritis and AVN. Exclusion criteria included revision hip arthroplasty, and cemented operations. A modification of the standard posterlateral approach was used. Standard hip arthroplasty instruments along with curved acetabular reamers and impactor were used. Incision extent was determined by the size of the acetabular component. A fully Hidroxyapetite coated stem, and porous coated acetabullar component were used. Immediate full weight bearing postoperative regimen was allowed in all cases. Results: In 17 patients (group A) the indication for surgery was a recent subcapital fracture. 74 patients (group B) had no trauma. The average age was 64.2 in group A and 65.1 in group B. No case of deep infection was documented in either group. 5 patients in group B had a single event of a posterior dislocation that was treated successfully with closed reduction. No dislocation occurred in group A. 35% (4) of group A and 41% (22) of group B did not require postoperative blood transfusions. 47% (6) and 36% (14) respectively needed transfusion of 3 blood units or more. Average hospitalization time was 6 days. None of the patients in both groups needed re-operation. Conclusions: