Effect of Tranexamic Acid on Hematologic Values and Blood Loss in Reverse Total Shoulder Arthroplasty

Overview

Journal Biomed Res Int

Publisher Wiley

Specialties Biomedical Engineering
Biotechnology
General Medicine

Date 2017 Aug 19

PMID 28819631

Citations 13

Authors

Sae Hoon Kim

Whan Ik Jung

Young Jun Kim

Do Hyeon Hwang

Young Eun Choi

Affiliations

Soon will be listed here.

Abstract

Purpose: Use of tranexamic acid (TXA) in the setting of arthroplasty of the lower extremity has been previously described. The aim of this study was to evaluate the benefit of a single dose of TXA (500 mg vial) administered intravenously just prior to RTSA in an Asian population.

Methods: The records of 48 patients (no TXA, = 24, versus TXA, = 24) that underwent RTSA for cuff tear arthropathy were retrospectively reviewed. All patients had a Hemovac drain positioned for 2 days after surgery. Hemoglobin (Hb) and hematocrit (Hct) were checked on postoperative day 2 and compared with preoperative levels.

Results: Hematologic change on postoperative day 2 as determined by Hb level after surgery was statistically lower in the TXA group (2.8 ± 0.8 versus 2.1 ± 0.8 (mg/dL), = 0.006). Mean fall in Hct level was also significantly less in the TXA group (8.0 ± 2.5 versus 6.1 ± 2.6 (L/L), = 0.012). Total Hemovac drainage tended to be lower in the TXA group (263.4 ± 129.3 versus 203.5 ± 84.2 (ml), = 0.064). TXA was found to have no noticeable side effects.

Conclusion: The use of a single intravenous dose of TXA immediately prior to RTSA reduces hematologic deterioration postoperatively and the amount of Hemovac drainage. TXA could avoid unnecessary transfusion and its associated medical side effects and cost.

Citing Articles

A Retrospective Study on the Role of Tranexamic Acid in Reverse Total Shoulder Arthroplasty for Trauma Patients With Complex Proximal Humerus Fractures.

Rana T, Mushtaq H, Memon K, Chan S, Kalogrianitis S Cureus. 2025; 17(1):e78083.

PMID: 40013204 PMC: 11864774. DOI: 10.7759/cureus.78083.

Sex differences in inflammatory parameters after shoulder arthroplasty and blood loss.

Hertling S, Schleussner E, Loos F, Eckhardt N, Kaiser M, Graul I Front Surg. 2024; 11:1264443.

PMID: 39512731 PMC: 11541230. DOI: 10.3389/fsurg.2024.1264443.

Tranexamic acid achieves less blood loss volume of in primary shoulder arthroplasty: a systematic review and meta-analysis of level I randomized controlled trials.

Fan D, Ma J, Zhang L JSES Rev Rep Tech. 2023; 1(4):344-352.

PMID: 37588711 PMC: 10426620. DOI: 10.1016/j.xrrt.2021.05.005.

Efficacy and safety of intravenous tranexamic acid in total shoulder arthroplasty: A meta-analysis.

Deng H World J Clin Cases. 2023; 11(13):2992-3001.

PMID: 37215404 PMC: 10198082. DOI: 10.12998/wjcc.v11.i13.2992.

Evaluating the effectiveness of tranexamic acid administration in reducing bleeding in benign prostate hyperplasia patients underwent open prostatectomy: A double-blind randomized clinical trial.

Sichani M, Mohammadi S, Khorrami M, Zargham M, Javid A, Dehghani M J Res Med Sci. 2023; 28:8.

PMID: 36974110 PMC: 10039104. DOI: 10.4103/jrms.jrms_308_22.

References

Chang C, Chang Y, Chen D, Ueng S, Lee M . Topical tranexamic acid reduces blood loss and transfusion rates associated with primary total hip arthroplasty. Clin Orthop Relat Res. 2014; 472(5):1552-7. PMC: 3971210. DOI: 10.1007/s11999-013-3446-0. View

Benoni G, Fredin H . Fibrinolytic inhibition with tranexamic acid reduces blood loss and blood transfusion after knee arthroplasty: a prospective, randomised, double-blind study of 86 patients. J Bone Joint Surg Br. 1996; 78(3):434-40. View

Wang H, Shen B, Zeng Y . Comparison of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled and prospective cohort trials. Knee. 2014; 21(6):987-93. DOI: 10.1016/j.knee.2014.09.010. View

Friedman R, Gordon E, Butler R, Mock L, Dumas B . Tranexamic acid decreases blood loss after total shoulder arthroplasty. J Shoulder Elbow Surg. 2015; 25(4):614-8. DOI: 10.1016/j.jse.2015.09.014. View

Cuff D, Pupello D, Virani N, Levy J, Frankle M . Reverse shoulder arthroplasty for the treatment of rotator cuff deficiency. J Bone Joint Surg Am. 2008; 90(6):1244-51. DOI: 10.2106/JBJS.G.00775. View

Jiang J, Toor A, Shi L, Koh J . Analysis of perioperative complications in patients after total shoulder arthroplasty and reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2014; 23(12):1852-1859. DOI: 10.1016/j.jse.2014.04.008. View

Schairer W, Nwachukwu B, Lyman S, Craig E, Gulotta L . National utilization of reverse total shoulder arthroplasty in the United States. J Shoulder Elbow Surg. 2014; 24(1):91-7. DOI: 10.1016/j.jse.2014.08.026. View

Abildgaard J, McLemore R, Hattrup S . Tranexamic acid decreases blood loss in total shoulder arthroplasty and reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2016; 25(10):1643-8. DOI: 10.1016/j.jse.2016.02.002. View

Boileau P, Watkinson D, Hatzidakis A, Hovorka I . Neer Award 2005: The Grammont reverse shoulder prosthesis: results in cuff tear arthritis, fracture sequelae, and revision arthroplasty. J Shoulder Elbow Surg. 2006; 15(5):527-40. DOI: 10.1016/j.jse.2006.01.003. View

10.

Werner C, Steinmann P, Gilbart M, Gerber C . Treatment of painful pseudoparesis due to irreparable rotator cuff dysfunction with the Delta III reverse-ball-and-socket total shoulder prosthesis. J Bone Joint Surg Am. 2005; 87(7):1476-86. DOI: 10.2106/JBJS.D.02342. View

11.

Klatsky A, Armstrong M, Poggi J . Risk of pulmonary embolism and/or deep venous thrombosis in Asian-Americans. Am J Cardiol. 2000; 85(11):1334-7. DOI: 10.1016/s0002-9149(00)00766-9. View

12.

Kagoma Y, Crowther M, Douketis J, Bhandari M, Eikelboom J, Lim W . Use of antifibrinolytic therapy to reduce transfusion in patients undergoing orthopedic surgery: a systematic review of randomized trials. Thromb Res. 2008; 123(5):687-96. DOI: 10.1016/j.thromres.2008.09.015. View

13.

Panteli M, Papakostidis C, Dahabreh Z, Giannoudis P . Topical tranexamic acid in total knee replacement: a systematic review and meta-analysis. Knee. 2013; 20(5):300-9. DOI: 10.1016/j.knee.2013.05.014. View

14.

Gruson K, Accousti K, Parsons B, Pillai G, Flatow E . Transfusion after shoulder arthroplasty: an analysis of rates and risk factors. J Shoulder Elbow Surg. 2009; 18(2):225-30. DOI: 10.1016/j.jse.2008.08.005. View

15.

Zakai N, McClure L, Judd S, Safford M, Folsom A, Lutsey P . Racial and regional differences in venous thromboembolism in the United States in 3 cohorts. Circulation. 2014; 129(14):1502-9. PMC: 4098668. DOI: 10.1161/CIRCULATIONAHA.113.006472. View

16.

Klein H . Allogeneic transfusion risks in the surgical patient. Am J Surg. 1995; 170(6A Suppl):21S-26S. DOI: 10.1016/s0002-9610(99)80054-3. View

17.

Limdi N, Wadelius M, Cavallari L, Eriksson N, Crawford D, Lee M . Warfarin pharmacogenetics: a single VKORC1 polymorphism is predictive of dose across 3 racial groups. Blood. 2010; 115(18):3827-34. PMC: 2865873. DOI: 10.1182/blood-2009-12-255992. View

18.

Weber C, Gorlinger K, Byhahn C, Moritz A, Hanke A, Zacharowski K . Tranexamic acid partially improves platelet function in patients treated with dual antiplatelet therapy. Eur J Anaesthesiol. 2010; 28(1):57-62. DOI: 10.1097/EJA.0b013e32834050ab. View

19.

Perera M, Gamazon E, Cavallari L, Patel S, Poindexter S, Kittles R . The missing association: sequencing-based discovery of novel SNPs in VKORC1 and CYP2C9 that affect warfarin dose in African Americans. Clin Pharmacol Ther. 2011; 89(3):408-15. PMC: 3625373. DOI: 10.1038/clpt.2010.322. View

20.

Lin P, Hsu C, Chen W, Wang J . Does tranexamic acid save blood in minimally invasive total knee arthroplasty?. Clin Orthop Relat Res. 2011; 469(7):1995-2002. PMC: 3111781. DOI: 10.1007/s11999-011-1789-y. View