DOS Kongressen 2014 ·
151
Low Occurrence of Thromboembolic Events After
Routine Use of Tranexamic Acid in Hip and Knee
Arthroplasty
Rune Vinther Madsen, Christian Skovgaard Nielsen, Thomas Kallemose,
Henrik Husted, Anders Troelsen
CORH - Clinical Orthopaedic Research Hvidovre, Dept. of Orthopaedic
Surgery, Copenhagen University Hospital Hvidovre, Denmark
Background:
Tranexamic acid (TXA) has, for many years, been used to reduce
bleeding in both elective and trauma patients. TXA´s blood reducing effect is
well documented. However, the still existing skepticism for routine use of TXA
in elective hip and knee replacement surgeries is due to the lack of studies with
larger cohorts providing documentation of the risk for thromboembolic compli-
cations after routine administration of TXA.
Purpose / Aim of Study:
The objective of this study was to investigate the
occurrence of thromboembolic complications after routine use of TXA in hip and
knee replacement surgeries.
Materials and Methods:
We identified all 3175 patients, who underwent sur-
gery with hip or knee replacement at Hvidovre Hospital between November
2007 and March 2013. Data was then extracted from The Danish National
Patient Registry focusing on post-operative thromboembolic complications,
which were divided into subgroups (deep venous thrombosis, acute myocardial
infarction and pulmonary embolism), occurring up to 90 days post-operatively.
TXA, bolus i.v. 1 g, was administered pre-operatively, and patients were admit-
ted in a well-documented fast-track set-up focusing on early mobilization.
Findings / Results:
Of the 3175 patients, 398 did not receive TXA during
their hip or knee replacement surgery. Of the remaining 2777 patients, who all
received TXA during their surgery, respectively 13 (=0.5%), 6 (=0.2%) and 8
(=0.3%) patients suffered from symptomatic deep venous thrombosis, pulmo-
nary embolism or acute myocardial infarction within 90 days post-operatively.
Conclusions:
The findings suggest that routine use of TXA in hip and knee re-
placement surgeries is safe with a low occurrence of thromboembolic complica-
tions. However, other factors, such as early mobilization, may play a significant
role in diminishing thromboembolic events.
98.
