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Clotting drug may cut blood transfusion need for hip patients

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Patients undergoing hip or knee replacement surgery could benefit from taking a clotting drug before their operation, new research suggests.

Giving patients tranexamic acid can reduce the need for a blood transfusion while not increasing the risk of complications, experts found.

The drug has been linked to a reduction of blood loss during surgery, but concerns have been raised over the safety of taking the medication.

“Tranexamic acid was effective in reducing the need for blood transfusions while not increasing the risk of complications”

Study authors

A team of US researchers examined data concerning almost 900,000 patients having hip or knee replacements at 510 US hospitals between 2006 and 2012.

Their study, published in The British Medical Journal, found that the use of tranexamic acid was associated with a 69% reduction for the need of blood transfusions and was not associated with an increased risk in complications.

The authors said: “Tranexamic acid was effective in reducing the need for blood transfusions while not increasing the risk of complications, including thromboembolic events and renal failure.

“Thus, our data provide incremental evidence of the potential effectiveness and safety of tranexamic acid in patients requiring orthopedic surgery,” said the team from Weill Cornell Medical College in New York.

They added: “The prudent identification of patients most likely to benefit from tranexamic acid − that is, those at increased risk of bleeding − is warranted.”

However, in an accompanying editorial, experts from the London School of Hygiene and Tropical Medicine said it would be “premature to recommend the routine use of tranexamic acid in general and orthopaedic surgery.”

They pointed out ambiguities over the risk of complications − for instance post-op heart attacks often go undetected − and called for a separate trial to resolve the uncertainties.

In England and Wales, around 180,000 hip and knee replacements are carried out each year.


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Readers' comments (1)

  • May be good news then. A friend of mine has just had new hip and the anti-coagulant has caused wound bleeding and substantial bruising of hands and arms. Because her bp dropped after the 1st day, blood transfusions were THEN given, though not needed at the time of op. Strange that the anaemia was only detected the day after the op!

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