Safety and efficacy of tranexamic acid in hip hemiarthroplasty: A retrospective review of perioperative outcome

In low-income nations, hemiarthroplasty, majorly unipolar hemiarthroplasty (Austin Moore implant), is commonly used for treating femoral neck fractures, often causing significant blood loss. Studies on elective endoprosthetic surgery have shown tranexamic acid (TXA) effectively reduces blood loss and postoperative complications. This study aims to assess how safe and effective a single-dose of intravenous TXA is for older patients having hip hemiarthroplasty, looking specifically at the need for blood transfusions, blood loss, kidney function, and blood clotting. This cohort study focuses on individuals aged 60 or older who had hip hemiarthroplasty at a major tertiary care facility affiliated with a university between January 2016 and June 2023. The study analyzes transfusion rates, surgical complications, and patient demographics over a period of time. Of the 231 patients, 153 were given a regular dose of TXA prior to surgery, and 78 did not. The TXA and non-TXA groups had mean ages of 68.52 ± 4.32 and 68.34 ± 2.63, respectively. TXA treatment was associated with less blood loss (223.95 ± 112.67 vs 357.69 ± 206.50 mL, P < .001) and a shorter surgical recovery period ( P = .01). Postoperative hemoglobin levels rose in the TXA group ( P = .70), but they fell in the non-TXA group ( P < .01). Significant variations were noted in Hct, platelet count, and PT across the groups ( P < .05). Single-dose TXA in elderly patients undergoing hip hemiarthroplasty was associated with reduced transfusion requirements and stable postoperative renal and coagulation profiles. These findings suggest its potential perioperative benefit, although larger studies are needed to confirm these results.