Efficacy And Safety Of Rivaroxaban After Application Of Tranexamic Acid In Total Hip Arthroplasty

Objective To research the Efficacy and safety of Rivaroxaban in reduction of blood loss after application of tranexamic acid (TXA) in total hip arthroplasty (THA)Methods One hundred and fifty patients undergoing unilateral primary THA between September 2012 and June 2015 were randomly divided into five groups (n=30). The group A was deemed as control,patients in group B received 10mg/kg TXA intravenously 10mins before the surgery,group C received 15mg/kg TXA intravenously 10mins before the surgery,group D received 15ml/kg TXA intravenously 10mins before the surgerynd and again 3 hours, group E received 15ml/kg TXA 10mins before the surgerynd and again 1 g TXA in articular cavity before closing the incision.The 10mg rivaroxabans were given when the volume of drainage was less then 30ml per hour after 6 h and applying to 35 d postoperative routine dose.The intraoperative blood loss,the postoperative flow,the total blood loss,the blood transfusion rate,the postoperative day 1 prothrombin time (PT),the activated partial thromboplastin time (APTT),the decrease of hemoglobin after removal of drainage tube,the postoperative deep vein thrombosis (DVT) and the incidence of pulmonary embolism (PE) were observed in Group A,B,C,D and E.R esults The intraoperative blood loss,the postoperative flow,the total blood loss,the blood transfusion rate,the decrease of hemoglobinafter after removal of drainage tube in five groups were statistically significant (P< 0.05).A11 patients were not found the DVT or PE in the perioperative period and postoperative 1 month or 3 months of outpatient or telephone follow-up.Conclusion Rivaroxaban in reduction of blood loss after application of TXA in THA is safe and efficient.Patients received 15ml/kg TXA intravenously 10mins before the surgerynd and again 3 hours is most effective in reducing bleedingor the reduction of blood loss during THA.