Konarski Wojciech, Derczyński Michał, Poboży Kamil, Domańska-Poboża Julia, Poboży Tomasz
Medical Rehabilitation Center, Sobieskiego 47D, 05-120 Legionowo, Poland.
Independent Researcher, 05-123 Olszewnica Stara, Poland.
J Clin Med. 2025 May 13;14(10):3399. doi: 10.3390/jcm14103399.
Avascular necrosis (AVN) of the femoral head is a major indication for total hip arthroplasty (THA), often associated with significant blood loss and high transfusion rates. Tranexamic acid (TXA) has been shown to reduce perioperative bleeding, but evidence in AVN-specific populations remains limited. This retrospective, single-center study analyzed 115 patients undergoing primary THA due to AVN between 2016 and 2023. Patients who received TXA were compared with those who did not. Baseline and perioperative data including hemoglobin (HGB), erythrocyte count (RBC), transfusion rates, and PRBC unit use were collected. Baseline characteristics were comparable between groups. TXA significantly reduced transfusion incidence (7.9% vs. 36.5%, < 0.0001) and total PRBC unit use (0.1 ± 0.3 vs. 0.8 ± 1.1, < 0.0001). The mean HGB drop was smaller in the TXA group (2.1 ± 1.2 vs. 3.2 ± 2.0 g/dL, = 0.001), as well as the RBC drop (0.8 ± 0.4 vs. 1.3 ± 1.4 million/μL, = 0.02). TXA effectively reduces blood loss and transfusion needs in AVN-related THA, supporting its routine perioperative use in this patient population.
股骨头缺血性坏死（AVN）是全髋关节置换术（THA）的主要指征，常伴有大量失血和高输血率。氨甲环酸（TXA）已被证明可减少围手术期出血，但在AVN特定人群中的证据仍然有限。这项回顾性单中心研究分析了2016年至2023年间因AVN接受初次THA的115例患者。将接受TXA的患者与未接受TXA的患者进行比较。收集了包括血红蛋白（HGB）、红细胞计数（RBC）、输血率和浓缩红细胞单位使用情况在内的基线和围手术期数据。两组之间的基线特征具有可比性。TXA显著降低了输血发生率（7.9%对36.5%，<0.0001）和浓缩红细胞单位的总使用量（0.1±0.3对0.8±1.1，<0.0001）。TXA组的平均HGB下降幅度较小（2.1±1.2对3.2±2.0 g/dL，=0.001），RBC下降幅度也较小（0.8±0.4对1.3±1.4百万/μL，=0.02）。TXA可有效减少AVN相关THA中的失血和输血需求，支持在该患者群体中围手术期常规使用TXA。
