Less Blood Loss With Tranexamic Acid in Primary Total Hip Arthroplasty Using the Direct Anterior Approach: a One-center Retrospective Observational Study

Background: It is still not known whether tranexamic acid is beneficial for the minimally invasive surgical approach to total hip arthroplasty (THA). This study seeks to investigate the efficacy and safety of intravenous tranexamic acid (TXA) in primary THA via the direct anterior approach (DAA). Methods: We performed a retrospective analysis of prospectively collected data on 70 patients with non-traumatic avascular necrosis of the femoral head who underwent total hip arthroplasty (THA) via the DAA between October 2017 and October 2018. Patients were divided into two groups: TXA group (39 patients who did receive 1.5g TXA intravenously) and control group (31 patients who did not receive TXA). Patients were assessed by the operative time, postoperative hemoglobin (HB) drop, transfusion rate, postoperative length of hospital stays (LHS), deep vein thrombosis (DVT), and Harris hip score (HHS).Results: The total blood loss, hidden blood loss, and postoperative HB drop in the TXA group were significantly lower than those in the control group (p < 0.05). There was no statistical difference in terms of intraoperative blood loss, operation time, transfusion rate, postoperative LHS, HHS, and the incidence of DVT between the two groups (p > 0.05). Conclusion: TXA may be reduce perioperative blood loss and not increase complications, in THA via the DAA.