Tranexamic Acid Use in Total Hip Arthroplasty for Avascular Necrosis: A Single-Center Experience

Wojciech Konarski, Michał Derczyński, Kamil Poboży, Julia Domańska, Tomasz Poboży

Background: Avascular necrosis (AVN) of the femoral head is a major indication for total hip arthroplasty (THA), often associated with significant blood loss and high transfusion rates. Tranexamic acid (TXA) has been shown to reduce perioperative bleeding, but evidence in AVN-specific populations remains limited. Methods: This retrospective, single-center study analyzed 115 patients undergoing primary THA due to AVN between 2016 and 2023. Patients who received TXA were compared with those who did not. Baseline and perioperative data including hemoglobin (HGB), erythrocyte count (RBC), transfusion rates, and PRBC unit use were collected. Results: Baseline characteristics were comparable between groups. TXA significantly reduced transfusion incidence (7.9% vs. 36.5%, p < 0.0001) and total PRBC unit use (0.1 ± 0.3 vs. 0.8 ± 1.1, p < 0.0001). The mean HGB drop was smaller in the TXA group (2.1 ± 1.2 vs. 3.2 ± 2.0 g/dL, p = 0.001), as well as the RBC drop (0.8 ± 0.4 vs. 1.3 ± 1.4 million/μL, p = 0.02). Conclusions: TXA effectively reduces blood loss and transfusion needs in AVN-related THA, supporting its routine perioperative use in this patient population.

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