• A Sassoon, D Nam, R Jackups, S R Johnson, R M Nunley, and R L Barrack.
• University of Washington, Meridian Ave N, Ste 270. Seattle, WA 98133, USA.
• Bone Joint J. 2016 Feb 1; 98-B (2): 173-8.

AimsThis study investigated whether the use of tranexamic acid (TXA) decreased blood loss and transfusion related cost following surface replacement arthroplasty (SRA).MethodsA retrospective review of patients treated with TXA during a SRA, who did not receive autologous blood (TXA group) was performed. Two comparison groups were established; the first group comprised of patients who donated their own blood pre-operatively (auto group) and the second of patients who did not donate blood pre-operatively (control). Outcomes included transfusions, post-operative haemoglobin (Hgb), complications, and length of post-operative stay.ResultsBetween 2009 and 2013, 150 patients undergoing SRA were identified for inclusion: 51 in the auto, 49 in the control, and 50 in the TXA group. There were no differences in the pre-operative Hgb concentrations between groups. The mean post-operative Hgb was 11.3 g/dL (9.1 to 13.6) in the auto and TXA groups, and 10.6 g/dL (8.1 to 12.1)in the control group (p = 0.001). Accounting for cost of transfusions, administration of TXA, and length of stay, the cost per patient was $1731, $339, and $185 for the auto, control and TXA groups, respectively.DiscussionTXA use demonstrated higher post-operative Hgb concentrations when compared with controls and decreased peri-operative costs.Take Home MessageTranexamic acid safely limits allogeneic transfusion, maintains post-operative haemoglobin, and decreases direct and indirect transfusion related costs in surface replacement arthroplasty.©2016 The British Editorial Society of Bone & Joint Surgery.

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