Efficacy of the Combined Administration of Systemic andIntra-Articular Tranexamic Acid in Total Hip ArthroplastySecondary to Femoral Neck Fracture: A Retrospective Study

Total hip arthroplasty (THA) is associated with substantial blood loss in the postoperative course. Tranexamic acid(TXA) is a potent antifibrinolytic agent, routinely administered by intravenous (IV) and topical (intra-articular, IA) route, whichcan possibly interrupt the cascade of events due to hemostatic irregularities close to the source of bleeding. However, scientificevidence of combined administration of TXA in THA secondary to a femoral neck fracture is still meagre. &e present study aimsto compare the patients who were administered combined IV and topical TXA with a control group in terms of blood loss,transfusion rate, and incidence of deep vein thrombosis (DVT) and thromboembolism (TE).Patients and Methods.195 patientswithfemoralneckfractureunderwentTHAandwereplacedintotwogroups:(1)IVandIATXAgroupwhichhad58patientsand(2) no TXA control group which had 137 patients. In the TXA group, 1g IV TXA was administered 30 minutes before incision,and1gIATXAwasadministeredintraoperativelyafterfasciaclosure.Nodrainswereplaced,andsoftspicawasappliedtothehip.Results. Combined usage of IV and IA TXA showed better results when compared to the control group in terms of bloodtransfusion rate (31%) and hemoglobin drop (28%). No cases of DVTor TE were noted among the two study groups.Conclusion.CombineduseofIV andIA TXAprovided significantlybetterresultscomparedto noTXAusewithrespecttoallvariablesrelatedto postoperative blood loss in THA. Moreover, TXA use is safe in terms of incidence of symptomatic DVT and TE.