Hip resurfacing and posterior approach total hip arthroplasty have equivalent blood loss when tranexamic acid is used: a propensity score matched cohort analysis
Introduction Hip resurfacing (HR) requires a larger approach and soft tissue dissection and might therefore be associated with increased blood loss compared to total hip arthroplasty (THA). However, the effect of the adoption of tranexamic acid (TXA) in this setting is unknown. Therefore, the curren...
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| Veröffentlicht in: | Archives of orthopaedic and trauma surgery 2022-12, Vol.142 (12), p.4055-4061 |
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| creator | Hanreich, Carola Su, Edwin Cororaton, Agnes Lyman, Stephen Jungwirth-Weinberger, Anna Boettner, Friedrich |
| description | Introduction
Hip resurfacing (HR) requires a larger approach and soft tissue dissection and might therefore be associated with increased blood loss compared to total hip arthroplasty (THA). However, the effect of the adoption of tranexamic acid (TXA) in this setting is unknown. Therefore, the current study compares the blood loss and transfusion requirements between HR and posterior THA in patients receiving TXA.
Materials and methods
This retrospective cohort study included patients undergoing primary, unilateral THA or HR using a posterior approach between February 2016 and 2020 in which TXA was administered. THA and HR patients were propensity score matched using nearest neighbor greedy matching accounting for demographic, health and surgical variables. Postoperative hemoglobin (Hgb) levels and Hgb drop from preoperative to post-operative day (POD) 1 were compared using t-tests and associated risk factors were assessed using linear mixed modelling.
Results
After matching, each cohort consisted of 1395 patients. Cohorts were similar regarding age, sex, BMI, and Charlson Comorbidity Index. No significant differences were found for Hgb levels on POD 1 (12.3 g/dl;
p
= 0.90) or Hgb drop (2.3 g/dl;
p
= 0.87). Duration of surgery was significantly longer for HR patients (82 vs 77 min;
p
|
| doi_str_mv | 10.1007/s00402-021-04272-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2618504282</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2728311187</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-b2d5e68be29da1a87f07683e3a9e9470a2ab0660e2490170cb15e369ada2c4203</originalsourceid><addsrcrecordid>eNp9kc1u1TAQRiMEoqXwAizQSGzYBMZ24iTsUAUUqRIbWEcTZ27jKjdOPU7hPg5viuGWH7Fg5ZF85ng8X1E8VfhSITavBLFCXaJWJVa60aW9V5yqylSl6ZS9_1d9UjwSuUZUuu3wYXFi6lyrujotvl34FSLLFnfk_HIFtIywBkkcfYhA6xoDuQlSSDTDlGGKaYphnUnSASa6ZeCbzd_SzEuCYQ5hhDmIwJeJF0iRFv5Ke-8g60fwApvw-BoIsnjlRXy2iAuRYU_JTTyCC1OIKQ9C80G8PC4e7GgWfnJ3nhWf3739dH5RXn58_-H8zWXpjLapHPRYs20H1t1Iitpmh41tDRvquKsaJE0DWousqw5Vg25QNRvb0UjaVRrNWfHi6M2D3Wwsqd97cTzP-Qdhk15b1dZ5z63O6PN_0OuwxTxvphrdGqVU22RKHykX8z4i7_o1-j3FQ6-w_xFgfwywzwH2PwPsbW56dqfehj2Pv1t-JZYBcwQkXy1XHP-8_R_td3pCqOs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2728311187</pqid></control><display><type>article</type><title>Hip resurfacing and posterior approach total hip arthroplasty have equivalent blood loss when tranexamic acid is used: a propensity score matched cohort analysis</title><source>SpringerLink Journals</source><creator>Hanreich, Carola ; Su, Edwin ; Cororaton, Agnes ; Lyman, Stephen ; Jungwirth-Weinberger, Anna ; Boettner, Friedrich</creator><creatorcontrib>Hanreich, Carola ; Su, Edwin ; Cororaton, Agnes ; Lyman, Stephen ; Jungwirth-Weinberger, Anna ; Boettner, Friedrich</creatorcontrib><description>Introduction
Hip resurfacing (HR) requires a larger approach and soft tissue dissection and might therefore be associated with increased blood loss compared to total hip arthroplasty (THA). However, the effect of the adoption of tranexamic acid (TXA) in this setting is unknown. Therefore, the current study compares the blood loss and transfusion requirements between HR and posterior THA in patients receiving TXA.
Materials and methods
This retrospective cohort study included patients undergoing primary, unilateral THA or HR using a posterior approach between February 2016 and 2020 in which TXA was administered. THA and HR patients were propensity score matched using nearest neighbor greedy matching accounting for demographic, health and surgical variables. Postoperative hemoglobin (Hgb) levels and Hgb drop from preoperative to post-operative day (POD) 1 were compared using t-tests and associated risk factors were assessed using linear mixed modelling.
Results
After matching, each cohort consisted of 1395 patients. Cohorts were similar regarding age, sex, BMI, and Charlson Comorbidity Index. No significant differences were found for Hgb levels on POD 1 (12.3 g/dl;
p
= 0.90) or Hgb drop (2.3 g/dl;
p
= 0.87). Duration of surgery was significantly longer for HR patients (82 vs 77 min;
p
< 0.01). Transfusion rate was 0.1% in both cohorts (
p
= 1.00). Hospital stay was significantly shorter for HR patients (1 vs 2 days;
p
< 0.01).
Conclusion
HR using a standard TXA regimen is not associated with greater perioperative blood loss than posterior THA and does not result in increased transfusion requirements. Both surgical procedures can be considered equally safe in terms of perioperative blood management when TXA is used.</description><identifier>ISSN: 1434-3916</identifier><identifier>ISSN: 0936-8051</identifier><identifier>EISSN: 1434-3916</identifier><identifier>DOI: 10.1007/s00402-021-04272-6</identifier><identifier>PMID: 35001154</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acids ; Antifibrinolytic agents ; Arthritis ; Cohort analysis ; Comorbidity ; Hip Arthroplasty ; Hip joint ; Hospitals ; Joint replacement surgery ; Medicine ; Medicine & Public Health ; Orthopedics ; Osteoarthritis ; Patients ; Risk factors</subject><ispartof>Archives of orthopaedic and trauma surgery, 2022-12, Vol.142 (12), p.4055-4061</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021</rights><rights>2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-b2d5e68be29da1a87f07683e3a9e9470a2ab0660e2490170cb15e369ada2c4203</cites><orcidid>0000-0002-7906-9486</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00402-021-04272-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00402-021-04272-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35001154$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hanreich, Carola</creatorcontrib><creatorcontrib>Su, Edwin</creatorcontrib><creatorcontrib>Cororaton, Agnes</creatorcontrib><creatorcontrib>Lyman, Stephen</creatorcontrib><creatorcontrib>Jungwirth-Weinberger, Anna</creatorcontrib><creatorcontrib>Boettner, Friedrich</creatorcontrib><title>Hip resurfacing and posterior approach total hip arthroplasty have equivalent blood loss when tranexamic acid is used: a propensity score matched cohort analysis</title><title>Archives of orthopaedic and trauma surgery</title><addtitle>Arch Orthop Trauma Surg</addtitle><addtitle>Arch Orthop Trauma Surg</addtitle><description>Introduction
Hip resurfacing (HR) requires a larger approach and soft tissue dissection and might therefore be associated with increased blood loss compared to total hip arthroplasty (THA). However, the effect of the adoption of tranexamic acid (TXA) in this setting is unknown. Therefore, the current study compares the blood loss and transfusion requirements between HR and posterior THA in patients receiving TXA.
Materials and methods
This retrospective cohort study included patients undergoing primary, unilateral THA or HR using a posterior approach between February 2016 and 2020 in which TXA was administered. THA and HR patients were propensity score matched using nearest neighbor greedy matching accounting for demographic, health and surgical variables. Postoperative hemoglobin (Hgb) levels and Hgb drop from preoperative to post-operative day (POD) 1 were compared using t-tests and associated risk factors were assessed using linear mixed modelling.
Results
After matching, each cohort consisted of 1395 patients. Cohorts were similar regarding age, sex, BMI, and Charlson Comorbidity Index. No significant differences were found for Hgb levels on POD 1 (12.3 g/dl;
p
= 0.90) or Hgb drop (2.3 g/dl;
p
= 0.87). Duration of surgery was significantly longer for HR patients (82 vs 77 min;
p
< 0.01). Transfusion rate was 0.1% in both cohorts (
p
= 1.00). Hospital stay was significantly shorter for HR patients (1 vs 2 days;
p
< 0.01).
Conclusion
HR using a standard TXA regimen is not associated with greater perioperative blood loss than posterior THA and does not result in increased transfusion requirements. Both surgical procedures can be considered equally safe in terms of perioperative blood management when TXA is used.</description><subject>Acids</subject><subject>Antifibrinolytic agents</subject><subject>Arthritis</subject><subject>Cohort analysis</subject><subject>Comorbidity</subject><subject>Hip Arthroplasty</subject><subject>Hip joint</subject><subject>Hospitals</subject><subject>Joint replacement surgery</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Osteoarthritis</subject><subject>Patients</subject><subject>Risk factors</subject><issn>1434-3916</issn><issn>0936-8051</issn><issn>1434-3916</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9kc1u1TAQRiMEoqXwAizQSGzYBMZ24iTsUAUUqRIbWEcTZ27jKjdOPU7hPg5viuGWH7Fg5ZF85ng8X1E8VfhSITavBLFCXaJWJVa60aW9V5yqylSl6ZS9_1d9UjwSuUZUuu3wYXFi6lyrujotvl34FSLLFnfk_HIFtIywBkkcfYhA6xoDuQlSSDTDlGGKaYphnUnSASa6ZeCbzd_SzEuCYQ5hhDmIwJeJF0iRFv5Ke-8g60fwApvw-BoIsnjlRXy2iAuRYU_JTTyCC1OIKQ9C80G8PC4e7GgWfnJ3nhWf3739dH5RXn58_-H8zWXpjLapHPRYs20H1t1Iitpmh41tDRvquKsaJE0DWousqw5Vg25QNRvb0UjaVRrNWfHi6M2D3Wwsqd97cTzP-Qdhk15b1dZ5z63O6PN_0OuwxTxvphrdGqVU22RKHykX8z4i7_o1-j3FQ6-w_xFgfwywzwH2PwPsbW56dqfehj2Pv1t-JZYBcwQkXy1XHP-8_R_td3pCqOs</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Hanreich, Carola</creator><creator>Su, Edwin</creator><creator>Cororaton, Agnes</creator><creator>Lyman, Stephen</creator><creator>Jungwirth-Weinberger, Anna</creator><creator>Boettner, Friedrich</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7906-9486</orcidid></search><sort><creationdate>20221201</creationdate><title>Hip resurfacing and posterior approach total hip arthroplasty have equivalent blood loss when tranexamic acid is used: a propensity score matched cohort analysis</title><author>Hanreich, Carola ; Su, Edwin ; Cororaton, Agnes ; Lyman, Stephen ; Jungwirth-Weinberger, Anna ; Boettner, Friedrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-b2d5e68be29da1a87f07683e3a9e9470a2ab0660e2490170cb15e369ada2c4203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Acids</topic><topic>Antifibrinolytic agents</topic><topic>Arthritis</topic><topic>Cohort analysis</topic><topic>Comorbidity</topic><topic>Hip Arthroplasty</topic><topic>Hip joint</topic><topic>Hospitals</topic><topic>Joint replacement surgery</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Osteoarthritis</topic><topic>Patients</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hanreich, Carola</creatorcontrib><creatorcontrib>Su, Edwin</creatorcontrib><creatorcontrib>Cororaton, Agnes</creatorcontrib><creatorcontrib>Lyman, Stephen</creatorcontrib><creatorcontrib>Jungwirth-Weinberger, Anna</creatorcontrib><creatorcontrib>Boettner, Friedrich</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Archives of orthopaedic and trauma surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hanreich, Carola</au><au>Su, Edwin</au><au>Cororaton, Agnes</au><au>Lyman, Stephen</au><au>Jungwirth-Weinberger, Anna</au><au>Boettner, Friedrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hip resurfacing and posterior approach total hip arthroplasty have equivalent blood loss when tranexamic acid is used: a propensity score matched cohort analysis</atitle><jtitle>Archives of orthopaedic and trauma surgery</jtitle><stitle>Arch Orthop Trauma Surg</stitle><addtitle>Arch Orthop Trauma Surg</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>142</volume><issue>12</issue><spage>4055</spage><epage>4061</epage><pages>4055-4061</pages><issn>1434-3916</issn><issn>0936-8051</issn><eissn>1434-3916</eissn><abstract>Introduction
Hip resurfacing (HR) requires a larger approach and soft tissue dissection and might therefore be associated with increased blood loss compared to total hip arthroplasty (THA). However, the effect of the adoption of tranexamic acid (TXA) in this setting is unknown. Therefore, the current study compares the blood loss and transfusion requirements between HR and posterior THA in patients receiving TXA.
Materials and methods
This retrospective cohort study included patients undergoing primary, unilateral THA or HR using a posterior approach between February 2016 and 2020 in which TXA was administered. THA and HR patients were propensity score matched using nearest neighbor greedy matching accounting for demographic, health and surgical variables. Postoperative hemoglobin (Hgb) levels and Hgb drop from preoperative to post-operative day (POD) 1 were compared using t-tests and associated risk factors were assessed using linear mixed modelling.
Results
After matching, each cohort consisted of 1395 patients. Cohorts were similar regarding age, sex, BMI, and Charlson Comorbidity Index. No significant differences were found for Hgb levels on POD 1 (12.3 g/dl;
p
= 0.90) or Hgb drop (2.3 g/dl;
p
= 0.87). Duration of surgery was significantly longer for HR patients (82 vs 77 min;
p
< 0.01). Transfusion rate was 0.1% in both cohorts (
p
= 1.00). Hospital stay was significantly shorter for HR patients (1 vs 2 days;
p
< 0.01).
Conclusion
HR using a standard TXA regimen is not associated with greater perioperative blood loss than posterior THA and does not result in increased transfusion requirements. Both surgical procedures can be considered equally safe in terms of perioperative blood management when TXA is used.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35001154</pmid><doi>10.1007/s00402-021-04272-6</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-7906-9486</orcidid></addata></record> |
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| ispartof | Archives of orthopaedic and trauma surgery, 2022-12, Vol.142 (12), p.4055-4061 |
| issn | 1434-3916 0936-8051 1434-3916 |
| language | eng |
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| source | SpringerLink Journals |
| subjects | Acids Antifibrinolytic agents Arthritis Cohort analysis Comorbidity Hip Arthroplasty Hip joint Hospitals Joint replacement surgery Medicine Medicine & Public Health Orthopedics Osteoarthritis Patients Risk factors |
| title | Hip resurfacing and posterior approach total hip arthroplasty have equivalent blood loss when tranexamic acid is used: a propensity score matched cohort analysis |
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