The efficacy of aggressive warming combined with tranexamic acid during total hip arthroplasty: a single-center retrospective study from southern China

F.-L. Li, Y. Huang, X. Huang, B.-F. Mo, W.-H. Liu, W.-W. Huang, D. Yin

Department of Joint Surgery and Sports Medicine, Department of Trauma, Microscopy and Hand Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Province, China. yindong@cug.edu.cn

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• Orthopedics

OBJECTIVE: The aim of the study was to evaluate the efficacy of aggressive warming combined with tranexamic acid (TXA) during total hip arthroplasty (THA).

PATIENTS AND METHODS: A total of 832 patients who underwent THA from October 2013 to June 2019 were divided into three groups according to the order of admission. There were 210 patients from October 2013 to March 2015 in group A, 302 patients from April 2015 to April 2017 in group B, and 320 patients from May 2017 to June 2019 in group C. Group A was the control group and was not given any measures. Group B was administered intravenously with 15 mg/kg TXA before skin incision and 3 h later without aggressive warming. Group C was administered intravenously with 15 mg/kg TXA before skin incision and 3 h later with aggressive warming. We evaluated the differences in the intraoperative blood loss, changes in core body temperature of patients at different stages during the operation, postoperative drainage, hidden blood loss, transfusion rate, drop of hemoglobin (Hb) on postoperative day 1 (POD1), prothrombin time (PT) of POD1, average hospitalization day, and complications.

RESULTS: There were statistically significant differences among the three groups during the intraoperative blood loss, intraoperative changes in core body temperature, postoperative drainage, hidden blood loss, blood transfusion rate, drop of Hb on POD1 and average hospital stay (p<0.05). There was no statistical difference in PT on POD1 and the incidence of complications (p>0.05).

CONCLUSIONS: Aggressive warming combined with TXA can significantly reduce the blood loss and transfusion rate of THA, and accelerate the recovery. We also observed that it does not increase the postoperative complications.

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