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Indian Journal of Orthopaedics Surgery


Hemiarthroplasty of Hip – A prospective study for Conservation of Blood Loss


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Author Details: M.A.Q. Ansari, M.M. Farhan, M. Nayeemuddin

Volume : 2

Issue : 2

Online ISSN : 2395-1362

Print ISSN : 2395-1354

Article First Page : 143

Article End Page : 146


Abstract

Background: Hemiarthroplasty of hip joint is a very commonly performed surgery. Several studies have been done which support the use of tranexamic acid in total knee joint replacements and few in total hip replacements. These studies have shown interesting positive results, but its benefits in hemiarthroplasty of hip joint have not yet widely known. This study aims to establish the role of tranexamic acid in reducing the intra and post-operative bleeding in case of hemiarthroplasty of hip.
Material and Methods: This is a prospective study of thirty four patients who underwent hip hemiarthroplasty for fracture neck of femur. The patients were divided as treatment (Group A; n=17) and control (Group B; n=17) group. All the patients were alternatively assigned these two groups. In group A, the patients who underwent surgeries around hip joint were given a bolus dose of tranexamic acid intravenously 10mg/kg body weight about 10 minutes before starting skin incision and in group B, equal volume of normal saline was injected. Total blood loss during surgery was calculated by weighing the mops used and soiled by blood and measuring the volume of blood accumulated in suction apparatus used for the surgery. Pre and postoperative haemoglobin levels were compared. The volume of fluid accumulated in the post-operative suction drain was also recorded and the data collected were analysed.
Results: The treatment group showed intra operative blood loss of <600ml in 64.7% of patients and none lost >1000ml blood. Drain fluid after twenty four hours was <100 ml in 70.6% and >150ml only in one (5.9%). The difference in pre and post-operative Hb levels was <1gm in 76.5% of patients.
Conclusion: Tranexamic acid given intravenously before surgical skin incision is very effective in conserving bleeding during hip hemiarthroplasty; the drug is of significant advantage as compared to the control group.

Key words:
Hemiarthroplasty, Blood loss, Tranexamic acid