Blood loss in Hip and Knee Replacements

Recent understanding and increased use of Tranexamic Acid (TXA) in hip and knee arthroplasties or replacements have seen the use of blood products for transfusion decrease. TXA is an anti-platelet medication used in other specialties safely for many years. A recent review study in Transfusion Medicine journal in May 2015; the effectiveness and safety of tranexamic acid in total hip or knee arthroplasty: a meta-analysis of 2720 cases, showed its effectiveness in reducing blood loss without any increased risks of blood clots or deep vein thrombosis (DVT).

Other surgical techniques like smaller wound sizes, minimally invasive approaches, decreased surgical operating time, use of special thermal devices, and tourniquets (for knee replacements) have all contributed to minimising blood loss during surgery.

In our practice, TXA is routinely given prior to major joint replacement surgery with no side effects. It has made blood transfusions a very rare occurrence.

By Dr Ray Chin, MBBS, FRACS (orth)
Consultant orthopaedic surgeon at South West Sydney Orthopaedics
Director of orthopaedic training at Liverpool Hospital