Effect of tranexamic acid on blood loss during THR in patients with inflammatory versus degenerative hip arthritis: A retrospective cohort study

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-03-17 DOI:10.1016/j.jcot.2025.102977

Mohabey Ankush, Sah Saurabh, Dwidmuthe Samir, Kotangale Pratik, Sahare Pratik

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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.

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氨甲环酸对炎性与退行性髋关节关节炎患者THR期间出血量的影响：一项回顾性队列研究

背景：氨甲环酸（TXA）越来越多地用于减少全髋关节置换术（THR）相关的失血，但其在全髋关节置换术期间炎症性关节炎与退行性关节炎的比较疗效在印度患者中仍未得到充分研究。本研究的目的是评估和比较有和没有给药TXA的THR患者的术中出血量，并根据潜在的退行性和炎症性关节状况分层。方法本回顾性队列研究分析了2020年10月至2023年10月在单一中心接受THR的患者的病历。根据TXA的使用和关节炎类型（炎症性和退行性）对患者进行分层。主要结局是术中出血量，次要结局包括手术时间和完全负重时间。结果共纳入126例患者，其中炎性关节炎21例，退行性关节炎105例，其中106例接受TXA治疗(炎性关节炎19例；N = 87，退行性关节炎)。TXA组的主要终点平均术中出血量（350.57±162.36 mL）低于非TXA组（380.00±192.22 mL），但差异无统计学意义（p = 0.472）。次要结果：接受TXA治疗的患者手术时间（88.53±24.38 min）明显短于未接受TXA治疗的患者（102.58±45.27 min, p = 0.046）。而到完全负重的时间在TXA使用者和非使用者之间是可比的（p = 0.341）。亚组分析表明，与炎性关节炎患者相比，退行性关节炎患者使用TXA后出血量的减少更为明显，但差异无统计学意义。结论在THR中应用txa可显著缩短手术时间，但对出血量和术后恢复无显著影响。结果表明，对退行性关节炎患者可能有更明显的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

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.