Effectiveness of Tranexamic Acid to Prevent Blood Loss in Patients Undergoing Hip Arthroplasty: A Randomised Controlled Study

Introduction: The safe and efficient Intravenous (i.v.) administration of Tranexamic Acid (TXA) has been shown to reduce blood loss and transfusion requirements following total hip replacement. However, its effectiveness in hip arthroplasty for femoral neck fractures remains a subject of debate to date. Aim: To evaluate the effects of TXA in patients undergoing hip arthroplasty to prevent blood loss. Materials and Methods: The present prospective, doubleblinded, randomised controlled study was conducted in in the Department of Orthopaedics, SRM Medical College Hospital and Research Institute (a tertiary care facility), Chengalpattu, Tamil Nadu, India, between August 2023 and January 2024. Study involved 138 participants with hip fractures classified into a TXA group (group A) and a placebo group (group B). The selected participants were monitored for blood loss, haemoglobin levels and blood transfusion volume. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 21.0, with t-tests and chisquare tests employed to compare participant characteristics. Results: In the present study, 69 of the 138 individuals received TXA in the interventional group, while 69 received a placebo in the control group. The mean±Standard Deviation (SD) age was 44.6±17.6 years in the interventional group and 48.5±16.4 years in the control group. Postoperatively, the interventional group exhibited a smaller decline in haemoglobin levels (12 g/dL vs. 11.0 g/dL). TXA significantly reduced transfusion volume (p-value <0.001). Additionally, blood loss was lower in patients receiving TXA (p-value <0.001). Conclusion: Treatment for hip fractures with TXA showed a tendency towards reduced blood loss and transfusions, as well as, a shortened total duration of surgery among the study participants. This indicates that TXA is safe and efficient in minimising blood loss during surgery.