Joint replacement surgery is a major orthopedic procedure which carries the risk of requiring a blood transfusion. Nearly 1 million joint replacements are performed in this country every year. While everything is done to avoid a transfusion, the occasional patient with heart disease or other medical problems may need blood in the process of recovery. While blood products these days are carefully screened for potential diseases, the risk is still there as the blood is coming from someone you do not know.
For some time, research has focused on ways to decrease the need for transfusions in these patients. A recent advance has received much attention in the orthopedic world, and now has an increasing database of evidence to support its use: Tranexamic Acid. This compound affects the ability of the body to break down clotted blood, and thus, reduces bleeding.
A recent study looked at over 800,000 patients between 2006 and 2012. The use of tranexamic acid resulted in a 70% decrease in the need for a transfusion after joint replacement surgery. The medication was also associated with lower rates of admission to an intensive care unit (ICU), lower length of hospital stay, and lower costs of hospital stay.
Many physicians voice concern regarding the potential for bloood clots – which can be a devastating complication of joint replacement surgery. The studies to date, including meta-analysis of multiple studies suggest that the risk of blood clots and pulmonary embolism are not increased by its use.
Certainly time will tell as more data becomes available, however based on what we know today, this may become the standard treatment in the course of surgery.
Another exciting step in the advancement of the art of joint replacement.
Dr. Scott Hacker is a Sports Medicine Orthopedic Surgeon in San Diego, CA, Team Surgeon to the US Olympic Team. He specializes in sports medicine and sports injuries, knee and shoulder surgery.
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If you have questions about joint replacement, or think you need a joint replacement, please feel free to contact me at Ask Dr. Hacker or through my office.
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