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The use of tranexamic acid in revision total hip arthroplasty: a pilot study

Background Revision total hip arthroplasty is becoming a more commonly performed procedure as patients are living longer and demanding more active lifestyles. However, these procedures can cause a significant amount of blood loss resulting in transfusions. Methods A double-blinded, randomized, controlled clinical trial was done to investigate the use of tranexamic acid in revision hip arthroplasty. Data collected included hemoglobin and hematocrit levels for the first 3 postoperative days, blood loss, allogenic blood transfusions, hospital stay, complications and cost of using tranexamic acid with regards to blood transfusions. A total of 10 patients (5 tranexamic acid and 5 placebo) were enrolled in the study. Results The placebo group averaged 3.6 ± 2.19 units of allogenic blood transfusions while the tranexamic acid group averaged 0.4 ± 0.89 units (P < 0.03). No significant difference was found in length of hospital stay between the placebo and tranexamic acid groups (4.8 days compared with 5.5 days, P = 0.52). No complications were reported. The cost of allogenic blood transfusions was reduced by approximately $800 per patient (P < 0.03) in the tranexamic acid group. Conclusions Tranexamic acid is effective in reducing allogenic blood transfusions in revision total hip arthroplasty. This drug is a viable option to minimize the use of allogenic blood transfusions in revision total hip arthroplasty surgeries.