Aims This study investigated whether the use of tranexamic acid (TXA) decreased blood loss and transfusion related cost following surface replacement arthroplasty (SRA).
Methods A retrospective review of patients treated with TXA during a SRA, who did not receive autologous blood (TXA group) was performed. Two comparison groups were established; the first group comprised of patients who donated their own blood pre-operatively (auto group) and the second of patients who did not donate blood pre-operatively (control). Outcomes included transfusions, post-operative haemoglobin (Hgb), complications, and length of post-operative stay.
Results Between 2009 and 2013, 150 patients undergoing SRA were identified for inclusion: 51 in the auto, 49 in the control, and 50 in the TXA group. There were no differences in the pre-operative Hgb concentrations between groups. The mean post-operative Hgb was 11.3 g/dL (9.1 to 13.6) in the auto and TXA groups, and 10.6 g/dL (8.1 to 12.1)in the control group (p = 0.001). Accounting for cost of transfusions, administration of TXA, and length of stay, the cost per patient was $1731, $339, and $185 for the auto, control and TXA groups, respectively.
Discussion TXA use demonstrated higher post-operative Hgb concentrations when compared with controls and decreased peri-operative costs.
Take home message: Tranexamic acid safely limits allogeneic transfusion, maintains post-operative haemoglobin, and decreases direct and indirect transfusion related costs in surface replacement arthroplasty.
Cite this article: Bone Joint J 2016;98-B:173–8.
A. Sassoon: Data collection, data analysis, manuscript preparation.
D. Nam: Data analysis, study design, manuscript preparation.
R. Jackups: Data analysis, contributed to methodology and study design, manuscript preparation.
S. R. Johnson: Data collection, data analysis, manuscript preparation.
R. M. Nunley: Manuscript preparation, data analysis, performed surgeries.
R. L. Barrack: Study design, manuscript preparation, performed surgeries.
The authors would like to acknowledge Dr. J. C. Clohisy for his contribution of patients to this investigation.
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
This article was primary edited by S. P. F Hughes and first proof edited by G. Scott.
Supplementary material. Tables showing estimated blood loss and length of stay are available alongside the online version of this article at www.bjj.boneandjoint.org.uk
- Received June 24, 2015.
- Accepted September 10, 2015.
- ©2016 The British Editorial Society of Bone & Joint Surgery