Tranexamic Acid Use Is Associated With Lower Rates of Transfusion in Patients Undergoing Revision Total Hip Arthroplasty for Periprosthetic Joint Infection.

Sahil S Telang, Julian Wier, Pranit Kumaran, Steven H Liu, Jacob Becerra, Jay R Lieberman, Nathanael D Heckmann

Abstract read

In one paragraph

Article in Arthroplasty today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Sahil S TelangDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Julian WierDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Pranit KumaranDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Steven H LiuDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Jacob BecerraDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Jay R LiebermanDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Nathanael D HeckmannDepartment of Orthopaedic Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: While tranexamic acid (TXA) is widely used in primary total hip arthroplasty (THA), it has not been studied extensively during revision THA for periprosthetic joint infection (PJI). Since revision procedures for infection are associated with greater intraoperative blood loss and a higher likelihood of transfusion, investigation of TXA use in first-stage revision THA for PJI is warranted to define its impact on postoperative bleeding risk, transfusion requirements, and safety profile. Methods: Querying a large healthcare database, we identified adult patients between 2016 and 2023 undergoing stage-one revision THA for PJI. Patients who received TXA were subsequently identified. Propensity score matching was used to balance cohorts. Mixed-effects logistic regression models were used to assess primary outcome, transfusion. Secondary outcomes included postoperative bleeding outcomes, wound complications, deep vein thrombosis, and pulmonary embolism. Results: After 1:1 propensity matching, 10,404 patients that had explanation of their THA and placement of an antibiotic spacer were included, with all hospital characteristics, patient demographics, and comorbidities demonstrating standardized mean differences <0.10. TXA-treated patients had significantly lower rates of postoperative transfusion (15.94% vs 17.78%; adjusted odds ratio = 0.86, 95% confidence interval [CI] = 0.76-0.99, Conclusions: TXA is associated with a reduction in postoperative transfusion and wound complications in patients undergoing revision THA for PJI.

Indexed as

Bleeding complicationsPeriprosthetic joint infectionRevision total hip arthroplastyTotal hip arthroplastyTranexamic acidTransfusion

Identifiers

PMID42631014

DOI10.1016/j.artd.2026.102106

PMCPMC13495081

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