Intravenous tranexamic acid is associated with safe reduced blood loss and transfusion rate in one-stage exchange for infected hip arthroplasty
Hussein Abdelaziz1*, Ahmed Chaabene1*, Juan Schulmeyer2, Thorsten Gehrke1, Carl Haasper3, Nael Hawi4, Mustafa Citak1
1Department of Orthopaedic Surgery, Helios ENDO-Klinik Hamburg, Hamburg, Germany
2Department of Orthopaedic Surgery and Trauma, Hospital Barros Luco Trudeau, Gran Avenida Jose Miguel, Santiago, Chile
3Department of Orthopaedic Surgery, AMEOS Klinikum Seepark, Geestland, Geestland, Germany
4Department of Trauma Surgery, Hannover Medical School, Hannover, Germany
Keywords: Blood loss, blood transfusion, infected hip arthroplasty, intravenous, one-stage exchange, tranexamic acid
Objectives: This study aims to investigate if the use of intravenous (IV) tranexamic acid (TXA) during one-stage exchange for periprosthetic joint infection (PJI) of the hip that necessitates an extensive debridement is associated with decreased blood loss, if the rate of blood transfusion that may lead to side effects can be lowered with IV TXA, and if there is any difference regarding the occurrence of postoperative venous thromboembolism (VTE).
Patients and methods: We retrospectively reviewed patients who underwent one-stage exchange for PJI of the hip with perioperative IV administration of TXA (n=163; 90 males, 73 females; mean age 68±10.3; range, 25 to 90 years) between January 2015 and December 2016 and compared them to another group (n=190; 106 males, 84 females; mean age 71±10.1; range, 39 to 92 years) who underwent one-stage exchange for PJI of the hip without perioperative IV administration of TXA between January 2006 and December 2012. Blood loss, transfusion rates, amount of transfused blood, and occurrence of VTE complications were observed.
Results: Mean blood loss of the TXA group was significantly lower than that of the non-TXA group (2.4 L and 4.5 L, respectively; p<0.001). Patients in non-TXA group experienced significantly higher rate of blood transfusion (71.1% and 58.3%, respectively; p=0.014) and higher quantity of transfused packed red blood cells (3.2 and 1.9 units, respectively; p<0.001). There was one patient with VTE complication in each group.
Conclusion: Even in the presence of infection, usage of IV TXA during one-stage exchange for PJI of the hip is associated with significantly lower blood loss and transfusion rates showing no higher risk of VTE events.
* Hussein Abdelaziz and Ahmed Chaabene have contributed equally in writing this manuscript
Citation: Abdelaziz H, Chaabene A, Schulmeyer J, Gehrke T, Haasper C, Hawi N, Citak M. Intravenous tranexamic acid is associated with safe reduced blood loss and transfusion rate in one-stage exchange for infected hip arthroplasty. Jt Dis Relat Surg 2021;32(1):17-21.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
We thank Mrs. Silke Lange for performing the statistical analysis in this study.