The Value of Routine Intravenous Tranexamic Acid in Total HipArthroplasty: A Preliminary Study

To determine the effect on the need for transfusion when intravenous tranexamic acid (TXA) is administeredintraoperatively in patients undergoing total hip arthroplasty (THA).Method. A prospective, double blinded, randomised controltrial of 88 patients undergoing THA was randomly allocated to receive 1 g of intravenous TXA or normal saline on induction ofanaesthesia. All patients received spinal anaesthesia. 'e primary outcome measure was transfusion rate, and the secondaryoutcomes were intraoperative blood loss, haemoglobin levels, length of hospital stay, functional scores, and thromboemboliccomplications.Results. 19.0% of patients given TXA required a blood transfusion, compared with 20.5% given placebo (p�0.87).Secondary outcomes included mean intraoperative blood loss, which was 536.5 ml in the TXA group and 469.8 ml in the placebogroup (p�0.276). Day 1 haemoglobin levels were 108.9 g/l in the TXA group versus 104.3 g/l in the placebo group (p�0.114).Day 4 haemoglobin levels were 105.0 g/l and 99.8 g/l, respectively (p�0.130). 'e mean length of stay in those who received TXAwas 4.3days, compared with 4.8days in those given placebo (p�0.20). 'e Oxford Hip Score showed a mean improvement over a1-year period of 25.9 points in those who received TXA, compared with 26.7 points in those who received placebo (p�0.679).'ere were two treatment emergent adverse events: a pulmonary embolism (TXA) and a myocardial infarction (placebo).Conclusions. 1 g IV TXA administered on induction did not significantly reduce the need for blood transfusion, postoperativeblood loss, functional scores, or the length of stay in patients undergoing THA. 'is trial is registeredwith ACTRN12610001065088.