Sefa Akti1, Hakan Zeybek2, Ahmet Burak Bilekli3, Nilgün Özgül Çelebi4, Yusuf Erdem3, Deniz Çankaya3

1Department of Orthopedics and Traumatology, Aksaray University Education And Research Hospital, Aksaray, Turkey
2Department of Orthopedics and Traumatology, Izmir Katip Çelebi University Atatürk Training Research Hospital, Izmir, Turkey
3Department of Orthopedics and Traumatology, Gülhane Teaching and Reseach Hospital, Ankara, Turkey
4Department of Statistics, Hacettepe University, Ankara, Turkey

Keywords: Hidden blood loss, total hip arthroplasty, tranexamic acid.


Objectives: In this study, we aimed to examine the effect of tranexamic acid (TXA) on hidden blood loss in total hip arthroplasty (THA) patients.

Patients and methods: Between June 2015 and June 2021, a total of 120 patients (45 males, 75 females; mean age 57.2±4.9 years; range, 45 to 67 years) with primary osteoarthritis who underwent THA without the use of TXA and 53 patients who received TXA were retrospectively analyzed. Demographic data, amount of transfusion, early complications, preoperative and postoperative hemoglobin and hematocrit values, total blood loss, visible blood loss, and hidden blood loss values were compared.

Results: There was a significant difference between the groups with and without the use of TXA in terms of intraoperative bleeding, amount of blood in the drain, total blood loss, hidden blood loss, and blood transfusion (p<0.05). A significant positive correlation was found between intraoperative blood loss and hidden blood loss (r=0.325 p<0.01), while no significant correlation was found between postoperative drainage volume and hidden blood loss (r=-0.006 p=0.946).

Conclusion: The use of TXA in patients undergoing THA reduces blood loss, including hidden blood loss, thereby reducing the need for blood transfusion after hip arthroplasty. However, there seems to be no linear relationship between postoperative blood loss and hidden blood loss. Considering these results, the routine use of TXA can be recommended in THA, unless there is a contraindication.

Citation: Akti S, Zeybek H, Bilekli AB, Özgül Çelebi N, Erdem Y, Çankaya D. The effect of tranexamic acid on hidden blood loss in total hip arthroplasty. Jt Dis Relat Surg 2022;33(1):102-108.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.