Efficacy Of Injection Around Articular Of Tranexamic Acid Use For After Operative Blood Loss And Functional Recovery In Primary Unilateral Total Hip Arthroplasty

Background: Tranexamic acid can significantly reduce the perioperative blood loss of hip and knee arthroplasty,however there is a great deal of argument about the mode of using tranexamic acid administration.Objective: To evaluate the efficacy and safety of injection around articular of tranexamic acid use for after operative blood loss and functional recovery in primary unilateral total hip arthroplasty.Methods: Primary unilateral total hip arthroplasty was performed on a total of 243 patients with femoral head necrosis combined with osteoarthritis of hip from January 2013 to January 2016 by retrospective cohort studying in the Handan Branch of Ji Zhong Engry Fengfeng Group Hospital.All the patients were divided into three groups according to random allocation.Male patients accounted for 131.Female patients accounted for 112.All of the patients ranged in age from 55 to 70 years.Their average age was(62.2±4.1)years.86 patients received 1.0 g tranexamic acid injection around articular capsule(tranexamic acid injection group).82 patients received 1.0 g tranexamic acid with a solution of 50.0 ml normal saline 20 minutes before operative incision(tranexamic acid intravenous drip group),and 75 patients did not accept TXA(no pharmacological intervention group).Three groups of patients were recorded with intraoperative blood loss,intraoperative blood transfusion volume,operation time,intraoperative blood transfusion rate and postoperative 24 hours drainage and postoperative blood transfusion volume,postoperative transfusion rate,thrombosis,postoperative Harris score.Three group of patients with total blood loss and hidden blood loss were calculated.Results: Tranexamic acid was performed on all patients successfully without any complications,such as infection of incisional wound,nonunion and fat liquefaction necrosis etc in the perioperative phase.No patients had appearance of side-effect of Tranexamic acid.Three groups of patients with gender,age,body mass index(BMI),course of disease,side,operation time,preoperative blood volume,intraoperative blood loss,intraoperative blood transfusion rate were not statistically significant(P>0.05).Postoperative blood transfusion volume: tranexamic acid injection group,tranexamic acid intravenous drip group and no drug intervention groups were statistically significant(P<0.05);tranexamic acid injection group and tranexamic acid intravenous drip group were no significant difference(P>0.05).Postoperative transfusion rate: tranexamic acid injection group,tranexamic acid intravenous drip group and no drug intervention groups were statistically significant(P<0.05);tranexamic acid injection group and tranexamic acid intravenous drip group were no significant difference(P>0.05).Hidden blood loss volume: tranexamic acid injection group,tranexamic acid intravenous drip group and no drug intervention groups were statistically significant(P<0.05);tranexamic acid injection group and tranexamic acid intravenous drip group were no significant difference(P>0.05).postoperative drainage volume: tranexamic acid injection group,tranexamic acid intravenous drip group and no drug intervention groups were statistically significant(P<0.05);tranexamic acid injection group and tranexamic acid intravenous drip group were no significant difference(P>0.05).Total blood loss volume: tranexamic acid injection group,tranexamic acid intravenous drip group and no drug intervention groups were statistically significant(P<0.05);tranexamic acid injection group and tranexamic acid intravenous drip group were no significant difference(P>0.05).Three groups of patients with postoperative Harris score were not statistically significant(P>0.05).Conclusion: Tranexamic acid applied in Primary unilateral total hip arthroplasty could reduce postoperative blood loss and rate of blood transfusion,and have no more risks in venous thrombosis of affected extremity.tranexamic acid injection group and tranexamic acid intravenous drip group were no significant difference of postoperative blood loss.The joint capsule around the injection of tranexamic acid had no effect on hip joint function after operation.