The use of tranexamic acid in patients submitted to primary total hip and knee arthroplasty: a single-center retrospective observational study

Introduction: This study aimed to determine the efficacy of intravenous tranexamic acid (TXA) in change in hemoglobin levels and need of red blood cell (RCB) transfusion following total hip arthroplasty (THA) and total knee arthroplasty (TNA) when compared with non-tranexamic acid treatment. Material and methods: We retrospectively reviewed 33 hips and 44 knees between January 2023 and December 2023. Outcome measures were hemoglobin drop (among postoperative first day), need of RBC transfusion, number of RBC units, hemoglobin levels among preoperative, and postoperative 1, 2, and 5 day. Results: Among THA patients, use of TXA compared to the non-TXA group was associated with a reduced need for RBC transfusion (12.5% vs. 32.0%; p = 0.496). Drop in hemoglobin levels within the first postoperative day was significantly greater in the non-TXA group (2.4 ± 1.12) compared to the TXA group (1.48 ± 0.53; p = 0.032). Among TKA patients, drop in hemoglobin levels on the first postoperative day was significantly smaller in the TXA group (1.05) than in the non-TXA group (2.31), with a significant p-value of < 0.001, with the need of RBC transfusion at 20% vs. 83.3%, respectively (p < 0.001). Conclusion: Our study supports the use of TXA as an effective measure to reduce the need for RBC transfusion in patients undergoing THA and TKA. The findings suggest that TXA may contribute to better postoperative outcomes by maintaining higher hemoglobin levels and reducing the need for transfusion.