ArticleArthroplasty today2018
Identifying the period of greatest blood loss after lower limb arthroplasty.
Article in Arthroplasty today, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 25 citations in OpenAlex.
- Perioperative Changes in Blood Volume and Fluid Distribution in Total Hip Arthroplasty-A Protocol for a Prospective Single-Center Observational Study.Acta anaesthesiologica Scandinavica · 2026Article
- The Impact of ABO Blood Type on Hemoglobin Decline After Total Hip Arthroplasty.Journal of clinical medicine · 2026Article
- Direct anterior total hip arthroplasty after hip arthroscopy: A retrospective review.Journal of orthopaedics · 2025Article
- The efficacy of oxidised regenerated cellulose powder in reducing blood loss during primary total hip arthroplasty: a retrospective cohort study.Journal of orthopaedic surgery and research · 2025Article
- Is Combining Two Different Routes of TXA Administration an Effective Blood Conserving Strategy for Total Knee Arthroplasty.Indian journal of orthopaedics · 2023Article
- Using tranexamic acid for an additional 24 hours postoperatively in hip and knee arthroplasty saves money: a cost analysis from the TRAC-24 randomized control trial.Bone & joint open · 2022Article
- Safety of wide-awake local anesthesia with no tourniquet (WALANT) in for lower limb surgery: A potential alternative in times of emergency.Frontiers in surgery · 2022Article
- The association between bone mineral density and postoperative drainage volume following cruciate-substituting primary total knee arthroplasty: a cross-sectional study.Knee surgery & related research · 2021Article
- Short-term outcomes of total knee arthroplasty performed with and without a tourniquet.SICOT-J · 2021Article
- Rapidly Progressive Osteoarthritis and Acetabular Bone Loss Outcomes for Patients Undergoing Primary Total Hip Replacement.Arthroplasty today · 2020Article
- Reply to the Letter to the Editor: Combined Intravenous and Intraarticular Tranexamic Acid Does Not Offer Additional Benefit Compared with Intraarticular Use Alone in Bilateral TKA: A Randomized Controlled Trial.Clinical orthopaedics and related research · 2020Article
- Letter to the Editor: Combined Intravenous and Intraarticular Tranexamic Acid Does Not Offer Additional Benefit Compared with Intraarticular Use Alone in Bilateral TKA: A Randomized Controlled Trial.Clinical orthopaedics and related research · 2020Article
- Efficacy of a three-day prolonged-course of multiple-dose versus a single-dose of tranexamic acid in total hip and knee arthroplasty.Annals of translational medicine · 2020Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of tranexamic acid (TXA) in total hip replacement (THR) typically reduces blood loss by approximately 400 mL, and typical total blood loss is still approximately 1 L. A barrier to harnessing the full potential of TXA is disagreement on the optimum timing of administration. To address this, we aimed to identify the period of greatest blood loss.
methodsWe analyzed the perioperative data of 870 patients who had undergone THR, total knee replacement, or unicompartmental knee replacement just before the introduction of TXA to our unit. Total blood loss was calculated on postoperative day (POD) 1 and POD2 using an equation based on change in hematocrit.
resultsAverage total blood loss at POD2 was 1505, 1322, and 611 mL for THR, total knee replacement, and unicompartmental knee replacement, respectively. Between 86% and 96% of this blood loss occurred in the period between skin closure and POD1. Intraoperative loss did not correlate with total loss at POD2. Blood transfusion was more likely if the patient was female (odds ratio [OR], 6.8) or if they had preoperative anemia (OR, 8.3) than if there was a high-volume blood loss (OR, 1.6).
conclusionsApproximately 90% of blood loss occurs between skin closure and the first postoperative 24 hours. "Intraoperative blood loss" and "transfusion rate" are not reliable markers of total blood loss. The full potential of TXA could be harnessed by using it during the period of greatest blood loss, that is, during the first postoperative 24 hours.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.