Abstract

Background: Total hip arthroplasty could be associated with major intra-operative as well as post-operative blood loss. Post-operative anaemia is a recognized complication which can prolong hospital stay, delay rehabilitation and is poorly tolerated by elderly patients. Blood transfusion carries the risk of infections, anaphylaxis, etc. We examined whether tranexamic acid given before and after total hip arthroplasty reduces intra-operative, post-operative and total operative blood loss and whether the need for post-operative blood transfusion is reduced.
Materials & Methods: A total of 40 patients were included in this study. Group A (n=20, study group) received I.V tranexamic acid (15mg/kg body weight) infusion 10 minutes before incision. 4 hours later, 10mg/kg body weight I.V tranexamic acid was given. Group B (n=20, control group) did not receive any anti fibrinolytic agent. The amount of blood loss, post-operative drop in haemoglobin and the amount of blood transfused was recorded in each case.
Results: Tranexamic acid significantly reduced intra-operative blood loss by 35.68% and total operative blood loss by 22.87% with a 30% reduction in blood transfusion rates compared to the control group. There was no significant effect on post-operative blood loss, duration of surgery or length of hospital stay.
Conclusion: Tranexamic acid when administered perioperatively significantly reduces the operative blood loss in primary total hip arthroplasty surgery with minor side effects. Thus, it can be used effectively in patients undergoing primary total hip arthroplasty to reduce intra-operative blood loss and the need for blood transfusions.