To explore the effect of local application of tranexamic acid (TXA) without drainage on blood loss in elderly patients with hip hemiarthroplasty.

A retrospective study was performed in 50 elderly cases of femoral neck fractures who had underwent hip hemiarthroplasty in department of Bone and Joint Surgery of Affiliated Hospital of Jining Medical University. Patients were randomly divided into the TXA group (n=25) and the control group (n=25). The TXA group received the intra-articular injection of 2 g TXA dissolved in 50 ml of normal saline, the control group received the intra-articular injection of the same volume of normal saline before closing the incision. The drainage tube was not used in both groups. The intraoperative blood loss, external blood loss, hidden blood loss, total blood loss, transfusion rate, postoperative hemoglobin concentration and complications were compared between the two groups.

The postoperative hemoglobin concentrations in the TXA group were higher than those in the control group (t=7.473, t=7.226, t=7.572, P<0.05). The total blood loss, external blood loss, hidden blood loss and blood transfusion rate were lower than those in the control group (t=7.881, t=15.353, t=7.225, t=5.781, P<0.05). There were no significant difference in the intraoperative blood loss and postoperative 3-hour-related blood coagulation indexes between the two groups (t=1.382, P<0.05). No deep vein thrombosis and pulmonary embolism occurred in the two groups. Each group had 1 case of intermuscular venous thrombosis, there was no significant difference between the two groups. There was no significant difference in the coagulation parameters between the two groups at 3 h after surgery (t=1.483, t=1.352, t=1.466, P>0.05).

Local application of tranexamic acid (TXA) without drainage can effectively reduce perioperative blood loss and transfusion rate, and does not increase the incidence of complications in the elderly patients with hip hemiarthroplasty.