Comparison of Intra-Articular and Intravenous Tranexamic Acid for Loss of Blood in Patients Undergoing Total Hip Replacement

Main Article Content

Kashif Jamal
Hafiz Muhammd Shiraz
Shuja Uddin
Usman Nazeer Gill
Namra Khalid
Usman Aslam

Abstract

Background: Tranexamic acid (TXA) is widely used in orthopedic surgeries to minimize blood loss, traditionally administered intravenously. Recent studies have explored intra-articular (IA) administration as a potentially more effective method due to its localized application and reduced systemic absorption.


Objective: To compare the effectiveness of IA and IV TXA in reducing blood loss in patients undergoing total hip replacement (THR).


Methods: This randomized controlled trial was conducted at Jinnah Hospital, Lahore, from August 30, 2019, to February 29, 2020, with approval from the Ethical Review Board. Seventy patients undergoing THR were enrolled and divided into two groups using a lottery system. Group A (n=35) received 1500 mg of IA TXA diluted in 100 ml of saline after implantation of THR components, while Group B (n=35) received 15 mg/kg of IV TXA five minutes before incision. Both groups were operated on using a lateral approach by the same surgeon. Postoperative blood loss was measured, and data were analyzed using SPSS version 20, with a p-value of <0.05 considered significant.


Results: The mean total blood loss in Group A was significantly lower at 446.23 ± 33.81 ml compared to Group B, which had a mean of 928.23 ± 43.93 ml (p-value = 0.0001). The results highlighted a marked reduction in blood loss with IA administration compared to IV.


Conclusion: IA administration of TXA during THR is more effective than IV administration in reducing total blood loss. This study supports the use of IA TXA as a safer, more efficient method for managing blood loss during hip replacement surgeries.

Article Details

How to Cite
Jamal, K., Shiraz, H. M., Uddin, S., Gill, U. N., Khalid, N., & Aslam, U. (2024). Comparison of Intra-Articular and Intravenous Tranexamic Acid for Loss of Blood in Patients Undergoing Total Hip Replacement. Journal of Health and Rehabilitation Research, 4(2), 250–255. https://doi.org/10.61919/jhrr.v4i2.768
Section
Articles
Author Biographies

Kashif Jamal, District Headquarter Hospital Nankana Sahab Pakistan.

Consultant Orthopedic Surgeon, District Headquarter Hospital Nankana Sahab, Pakistan.

Hafiz Muhammd Shiraz, District Headquarter Hospital Nankana Sahab Pakistan.

Consultant Orthopedic Surgeon, District Headquarter Hospital Nankana Sahab, Pakistan.

Shuja Uddin, Lahore General Hospital Lahore Pakistan.

Consultant Orthopedic Surgeon, Lahore General Hospital, Lahore, Pakistan.

Usman Nazeer Gill, Jinnah Hospital Lahore Pakistan.

Consultant Orthopedic Surgeon, Jinnah Hospital, Lahore, Pakistan.

Namra Khalid, District Headquarter Hospital Nankana Sahab Pakistan.

Consultant Orthopedic Surgeon, District Headquarter Hospital Nankana Sahab, Pakistan.

Usman Aslam, District Headquarter Hospital Nankana Sahab Pakistan.

Consultant Orthopedic Surgeon, District Headquarter Hospital Nankana Sahab, Pakistan.

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