{"title":"Effect of tranexamic acid on blood loss during THR in patients with inflammatory versus degenerative hip arthritis: A retrospective cohort study","authors":"Mohabey Ankush, Sah Saurabh, Dwidmuthe Samir, Kotangale Pratik, Sahare Pratik","doi":"10.1016/j.jcot.2025.102977","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Tranexamic acid (TXA) is increasingly used to minimize blood loss associated with total hip replacement (THR), yet its comparative efficacy in inflammatory versus degenerative arthritis during THR remains underexplored in Indian patients. The objective of this study was to evaluate and compare the estimated intraoperative blood loss in patients undergoing THR with and without TXA administration, stratified by underlying degenerative and inflammatory joint conditions.</div></div><div><h3>Methods</h3><div>This retrospective cohort study analyzed medical records of patients undergoing THR at a single center from October 2020 to October 2023. Patients were stratified by TXA usage and the type of arthritis (inflammatory and degenerative). The primary outcome was intraoperative blood loss, while secondary outcomes included operative time and time to full weight-bearing.</div></div><div><h3>Results</h3><div>The study enrolled 126 patients, including 21 with inflammatory arthritis and 105 with degenerative arthritis, of whom 106 received TXA (n = 19, inflammatory arthritis; n = 87, degenerative arthritis).</div><div>The primary outcome of mean intraoperative blood loss was lower in the TXA group (350.57 ± 162.36 mL) compared to the non-TXA group (380.00 ± 192.22 mL), although this difference did not reach statistical significance (p = 0.472).</div><div>Secondary outcome, operative time was significantly shorter in patients receiving TXA (88.53 ± 24.38 min) compared to those who did not receive TXA (102.58 ± 45.27 min, p = 0.046). While the time to full weight-bearing was comparable between the TXA users and non-users (p = 0.341).</div><div>Subgroup analysis suggested a more pronounced reduction in blood loss with TXA use among patients with degenerative arthritis than those with inflammatory arthritis, though the difference was not statistically significant.</div></div><div><h3>Conclusion</h3><div>TXA administration in THR significantly reduced operative time but showed no significant difference in blood loss or postoperative recovery. The results suggest a potential for more pronounced benefits in patients with degenerative arthritis.</div></div>","PeriodicalId":53594,"journal":{"name":"Journal of Clinical Orthopaedics and Trauma","volume":"65 ","pages":"Article 102977"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Orthopaedics and Trauma","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0976566225000736","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Background
Tranexamic acid (TXA) is increasingly used to minimize blood loss associated with total hip replacement (THR), yet its comparative efficacy in inflammatory versus degenerative arthritis during THR remains underexplored in Indian patients. The objective of this study was to evaluate and compare the estimated intraoperative blood loss in patients undergoing THR with and without TXA administration, stratified by underlying degenerative and inflammatory joint conditions.
Methods
This retrospective cohort study analyzed medical records of patients undergoing THR at a single center from October 2020 to October 2023. Patients were stratified by TXA usage and the type of arthritis (inflammatory and degenerative). The primary outcome was intraoperative blood loss, while secondary outcomes included operative time and time to full weight-bearing.
Results
The study enrolled 126 patients, including 21 with inflammatory arthritis and 105 with degenerative arthritis, of whom 106 received TXA (n = 19, inflammatory arthritis; n = 87, degenerative arthritis).
The primary outcome of mean intraoperative blood loss was lower in the TXA group (350.57 ± 162.36 mL) compared to the non-TXA group (380.00 ± 192.22 mL), although this difference did not reach statistical significance (p = 0.472).
Secondary outcome, operative time was significantly shorter in patients receiving TXA (88.53 ± 24.38 min) compared to those who did not receive TXA (102.58 ± 45.27 min, p = 0.046). While the time to full weight-bearing was comparable between the TXA users and non-users (p = 0.341).
Subgroup analysis suggested a more pronounced reduction in blood loss with TXA use among patients with degenerative arthritis than those with inflammatory arthritis, though the difference was not statistically significant.
Conclusion
TXA administration in THR significantly reduced operative time but showed no significant difference in blood loss or postoperative recovery. The results suggest a potential for more pronounced benefits in patients with degenerative arthritis.
期刊介绍:
Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.