Oral Tranexamic Acid in Hip and Knee Arthroplasty: A Prospective Cohort Study

作     者：Stephen McGrath Piers Yates Gareth Prosser 

作者机构：Department of Orthopaedic Surgery Fremantle Hospital Fremantle Australia 

出 版 物：《Open Journal of Orthopedics》 (矫形学期刊（英文）)

年 卷 期：2014年第4卷第8期

页      面：215-220页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Tranexamic Acid Blood Loss Surgical Blood Conservation Strategy Total Hip Replacement Total Knee Replacement 

摘      要：Intravenous Tranexamic acid has been shown to decrease blood transfusion requirements in sur- gery. Little evidence exists regarding the much cheaper oral form. The objective of this cohort study was to evaluate whether oral tranexamic acid administration in patients undergoing elec- tive hip and knee replacement surgery resulted in decreased transfusion requirements. Methods: We assessed the transfusion requirements of 332 patients following unilateral total hip or knee arthroplasty, with the first 140 receiving no tranexamic acid and the next 192 given 1 g oral tranexamic acid one hour prior to and a further 1 g 4 hours post joint arthroplasty. Haemoglobin before and after surgery, the number of units transfused post-operatively and the incidence of deep vein thrombosis or pulmonary embolism were recorded. Results: In the first group, there were 22 instances of transfusion (15.7%) and a mean haemoglobin drop of 32.2 g/L, while the second (tranexamic acid) group had just 12 patients transfused (6.3%) and a mean haemoglobin drop of 24.6 g/L (both significantly less, p 0.01). There was no significant difference in deep vein thrombosis or pulmonary embolism rates between groups. Conclusions: This is the first prospective study to analyze the outcome of oral tranexamic acid administration in hip and knee replacement. We conclude that oral tranexamic acid administration is a safe and effective means to decrease transfusion requirements in joint arthroplasty and is a much cheaper alternative to intravenous preparations of tranexamic acid.