Evaluation of intravenous tranexamic acid in total hip arthroplasty for femoral neck fracture: A propensity score-matched, real-world analysis.

Abstract

Background: The transfusion-sparing strategy in hip prosthetic surgery (Total Hip Arthroplasty, THA) is crucial. Tranexamic Acid (TXA) is a medication whose effectiveness has been demonstrated in numerous surgical indications to reduce bleeding and prevent the risk of blood transfusion.

Objective: To evaluate the impact of IV TXA on bleeding in THA for femoral neck fracture (FNF) surgery.

Methods: This single-center retrospective cohort study, conducted from January 2020 to September 2021, assessed patients undergoing THA for FNF, comparing those who received 1 g of IV TXA to those who did not, using a matched population through propensity score creation. Analyses were conducted univariately and multivariately.

Results: During the inclusion period, 175 patients underwent THA for FNF, with 87 receiving IV TXA and 88 not receiving TXA. After propensity score matching, the transfusion-free interval was better in the IV TXA treated group (p = 0,03). There was no difference in terms of perioperative bleeding or overall transfusion during hospitalization. There were no differences in the laboratory results at Days 1, 3, and 7.

Conclusion: IV TXA delays the need for transfusion in patients undergoing THA for FNF but does not reduce perioperative bleeding or transfusion during the stay.

Level of evidence: IV; retrospective study.