[Efficacy of single-dose preoperative tranexamic acid to prevent blood loss in total hip and knee joint replacement].

Acta ortopedica mexicana Pub Date : 2025-01-01

D Campos-Flores, F P Lameiro-Sánchez, A L Galicia-Zamalloa

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Abstract

Introduction: transfusion-related complications are a major concern for surgeons performing total hip and knee arthroplasty (THA and TKA). Several strategies have been implemented to reduce transfusion rates, including the use of tranexamic acid (TXA), whose optimal dosage remains a matter of debate.

Objective: to evaluate the efficacy and safety of a single pre-surgical dose of TXA in reducing blood loss in THA and TKA.

Material and methods: sixty patients were enrolled. Patients were randomly assigned to either a control group (no TXA) or an experimental group (1 g TXA 30 minutes before surgery). Blood loss, blood transfusion rate and volume, and hemoglobin levels were analyzed.

Results: hemoglobin loss in the control group was 3.5 ± 1.4 g/dl compared to 2.5 ± 1.5 g/dl in the experimental group (p = 0.006). Hematocrit loss was 10.6% ± 3.5 in the control group and 8% ± 4.9 in the experimental group (p = 0.02). Blood transfusion was only required in 3 patients (5%): 2 in the control group and 1 in the experimental group (p = 0.4).

Conclusions: a single pre-surgical intravenous dose of 1 g TXA reduces hemoglobin loss in patients undergoing THA and TKA.