Comparison Of Different Modes Of Tranexamic Acid Administration In Primary Total Hip Arthroplasty:A Prospective Study

Objective: To determine whether oral administration of tranexamic acid(TXA)was superior to intravenous or topical routines.Method:All patients undergoing primary THA were randomized to oral group(2 g TXA orally 2 hours preoperatively),intravenous group(20 mg/kg intravenous TXA bolus 5 minutes before the incision),and topical group(3gTXA applied topically).Reduction of hemoglobin,blood loss,transfusion rate,hospital stay,cost of TXA,adverse events,and coagulation functions were observed.Results : Demographic characteristics were similar among the 3 groups.The mean reduction of hemoglobin: oral group(34.6 ± 13.2)g / L;intravenous group(35.4 ± 10.7)g / L;topical group(36.5 ± 12.6)g / L;with no statistically significant differences(P > 0.05).Blood loss: oral group(1004 ± 415)ml;intravenous group(1032 ± 350)ml;topical group(1064 ±410)ml;with no statistically significant differences(P> 0.05).Transfusion rate(case): oral group 4;intravenous group 5;topical group 7;with no statistically significant differences(P >0.05).Hospital stay: oral group(5.43 ± 0.95)days;intravenous group(5.58 ± 1.17)days;topical group(5.41 ± 0.72)days;with no statistically significant differences(P > 0.05).Costs:oral group 40 yuan;intravenous group 3300 yuan;topical group 3550 yuan;with statistically significant differences(P<0.05).No deep venous thrombosis,pulmonary embolism,or infection was observed.There were no significant differences in the coagulation functions among the 3 groups(P > 0.05).Conclusion : The blood-sparing efficacy of oral TXA is comparable to that of the intravenous and topical routines.Oral TXA is recommended by its cost-benefit superiority and ease of administration.