Luo ZY, et al. - Researchers sought to compare the effectiveness of multiple doses of oral tranexamic acid (TXA) with topical TXA administration in reducing blood loss after total hip arthroplasty (THA). In the reduction of blood loss, oral TXA was equivalent to topical TXA administration in the setting of primary THA without drainage.

Methods

• In this double-blinded trial, authors randomized 117 patients undergoing primary THA to receive 2 g TXA orally 2 h preoperatively, and two doses of 1 g TXA postoperatively (oral group) or 3 g of TXA topical administration in the operating room (topical group).
• A reduction in hemoglobin concentration was the primary outcome.
• They recorded other outcomes-such as blood loss, TXA-related cost (¥), length of hospital stay (days), complications such as pulmonary thromboembolism (PE), deep vein thrombosis (DVT), and infection, blood coagulation and fibrinolysis, and hip function.

Results

• As per data, the mean reduction in hemoglobin level was similar between the oral and topical groups (3.07 g/dL compared with 3.12 g/dL; p=0.85).
• Findings suggested that similarly, between oral and topical administration there was no notable difference in the mean total blood loss (863 mL compared with 902 mL; p=0.62).
• Results demonstrated that an allogeneic blood transfusion was received by 3 patients, including 1 patient in the oral group and 2 patients in the topical group (p=0.55).
• A significantly lower TXA-related cost was seen in the oral group vs the topical group: ¥944 and ¥4359, respectively (p=0.01).
• Experts noted that no PE, DVT, cardiac infarction or renal failure occurred during the 90-day follow-up.
• Similar coagulation and fibrinolysis parameters were seen between the 2 groups.