Using TXA in Hip Fracture Surgery

Dr Seth Tarrant, an orthopaedic surgeon for the John Hunter Trauma Service, provides an overview of the evidence for the use of tranexamic acid acid in hip fracture surgery. This is followed by a Q&A with orthopaedic surgeon Dr Catherine McDougall.Watch the video version here. Highlighted studies:1. Palija, S., Bijeljac, S., Manojlovic, S., Jovicic, Z., Jovanovic, M., Cvijic, P., & Dragicevic-Cvjetkovic, D. (2021). Effectiveness of different doses and routes of administration of tranexamic acid for total hip replacement. International orthopaedics, 45(4), 865-870.2. Gayet-Ageron, A., Prieto-Merino, D., Ker, K., Shakur, H., Ageron, F. X., Roberts, I., ... & Pepple, T. (2018). Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe haemorrhage: a meta-analysis of individual patient-level data from 40 138 bleeding patients. The Lancet, 391(10116), 125-132.3. Zufferey, P. J., Miquet, M., Quenet, S., Martin, P., Adam, P., Albaladejo, P., ... & investigators of the tranexamic acid in hip-fracture surgery (THIF) study. (2010). Tranexamic acid in hip fracture surgery: a randomized controlled trial. British Journal of Anaesthesia, 104(1), 23-30.4. Tengberg, P. T., Foss, N. B., Palm, H., Kallemose, T., & Troelsen, A. (2016). Tranexamic acid reduces blood loss in patients with extracapsular fractures of the hip: results of a randomised controlled trial. The bone & joint journal, 98(6), 747-753.5. Zhou, X. D., Zhang, Y., Jiang, L. F., Zhang, J. J., Zhou, D., Wu, L. D., ... & Xu, N. W. (2019). Efficacy and Safety of Tranexamic Acid in Intertrochanteric Fractures: A Single‐Blind Randomized Controlled Trial. Orthopaedic surgery, 11(4), 635-642.6. Haj-Younes, B., Sivakumar, B. S., Wang, M., An, V. V., Lorentzos, P., & Adie, S. (2019). Tranexamic acid in hip fracture surgery: a systematic review and meta-analysis. Journal of Orthopaedic Surgery, 28(1), 2309499019887995.7. Nikolaou, V. S., Masouros, P., Floros, T., Chronopoulos, E., Skertsou, M., & Babis, G. C. (2021). Single dose of tranexamic acid effectively reduces blood loss and transfusion rates in elderly patients undergoing surgery for hip fracture: a randomized controlled trial. The Bone & Joint Journal, 103(3), 442-448.8. Ma, H., Wang, H., Long, X., Xu, Z., Chen, X., Li, M., ... & Liu, X. (2021). Early intravenous tranexamic acid intervention reduces post-traumatic hidden blood loss in elderly patients with intertrochanteric fracture: a randomized controlled trial. Journal of Orthopaedic Surgery and Research, 16(1), 1-7.9. You, D., Skeith, L., Korley, R., Cantle, P., Lee, A., McBeth, P., ... & Schneider, P. (2021). Identification of hypercoagulability with thrombelastography in patients with hip fracture receiving thromboprophylaxis. Canadian Journal of Surgery, 64(3), E324.Dr Seth Tarrant can be contacted via  [email protected].