Tranexamic Acid in Primary Total Hip Arthroplasty: Blood Loss and Transfusion Requirements
DOI:
https://doi.org/10.5281/zenodo.22327647Keywords:
Tranexamic acid, Total hip arthroplasty, Blood loss, Transfusion, Venous thromboembolismAbstract
Background: Perioperative blood loss and allogeneic transfusion remain important sources of morbidity and cost after primary
total hip arthroplasty (THA). Objective: To synthesise evidence on tranexamic acid (TXA) administration routes, dosing regimens, and their effect on blood loss, transfusion, and thromboembolic safety in primary THA. Methods: Narrative review of randomised trials, meta-analyses, network meta-analyses, cohort studies, and clinical practice guidelines on intravenous, topical, oral, and combined TXA regimens in primary THA. Findings: TXA reduces total blood loss by roughly 300 mL and lowers transfusion rates by 50-70% regardless of route, with intravenous, topical, and oral regimens showing broadly equivalent efficacy. Pooled registry data show no significant increase in venous thromboembolism, even with prior thromboembolic events. Conclusions: TXA is an effective, guideline-endorsed blood-conservation strategy in primary THA; route selection can reasonably be guided by cost and preference rather than expected differences in efficacy or safety.
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