A comparative study of local application versus intravenous application of tranexamic acid preoperatively in cases of total hip arthroplasty

Background
One of the biggest issues associated with total hip arthroplasties is the amount of blood loss and the need for blood transfusions. Tranexamic acid (TXA) has been proven to decrease the amount of blood loss associated with these operations. However, there is no consensus regarding the best method of TXA application. Classically, TXA had been given through the intravenous route, however, recent papers have advocated local usage. This study aimed to compare the outcomes between both local and intravenous applied TXA and determine which had less blood loss and adverse effects.


Results
Fifty patients were included in this study and were split into two groups. Group A was given local TXA, while group B took intravenous TXA. Blood loss showed no significant difference between the two groups. There were no significant differences in the incidence of adverse effects however, group B had one case of deep venous thrombosis and one case of superficial thrombosis.


Conclusion
Both local and intravenous applied TXA help decrease blood loss. There is no significant difference between the two groups in blood loss however deep venous thrombosis cases were observed in the intravenous group. In cases with a high risk of vascular thrombosis undergoing total hip arthroplasty, we would suggest applying TXA locally.