Subgroup Analysis of Topical Tranexamic Acid in Primary Total Hip Arthroplasty

Tranexamic acid (TXA) is an antifibrinolytic agent that can effectively be utilized for the reduction of blood loss when administered via intravenous or intraarticular injection following total joint arthroplasty. Despite data published to date, it remains unclear as to which specific patient groups undergoing primary total hip arthroplasty (THA) would benefit most regarding transfusion reduction from TXA administration. Using a retrospective cohort study model involving 123 THA patients who received topical TXA compared against 111 THA controls who did not receive TXA, we assessed data within the following subgroups: age, gender, BMI, preoperative hemoglobin, and surgical approach. Critical analysis of these subgroups revealed that the most reliable and consistent response to TXA was found in patients who were female and over 65 years old. Continued study of TXA administration in THA is essential to help reduce blood losses, minimize blood product transfusion, and improve outcomes following THA.