Prospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2015; 6(7): 521-527
Published online Aug 18, 2015. doi: 10.5312/wjo.v6.i7.521
Can tranexamic acid change preoperative anemia management during total joint arthroplasty?
Duy L Phan, Joseph B Rinehart, Ran Schwarzkopf
Duy L Phan, Ran Schwarzkopf, Department of Orthopaedic Surgery, University of California, Irvine, CA 92868, United States
Joseph B Rinehart, Department of Anesthesiology, University of California, Irvine, CA 92868, United States
Author contributions: Phan DL performed the data collection, statistical analysis, and wrote the paper; Rinehart JB designed the research study and revised the paper; Schwarzkopf R designed the research study and revised the paper.
Institutional review board statement: The study was reviewed and approved by the UCI Institutional Review Board.
Clinical trial registration statement: Because all study participants received the same treatment, the project was not registered as a clinical trial.
Informed consent statement: All study participants provided written consent prior to study enrollment.
Conflict-of-interest statement: Dr. Duy Phan has no relevant disclosures to make in relation to the submitted study. Dr. Phan has not received research funding, speaker fees, consulting fees, or royalties from any organizations. Dr. Phan is an employee of the Department of Orthopaedic Surgery, University of California, Irvine. Dr. Phan does not own company stock or options. Dr. Phan does not own any patents. Dr. Phan is not on the editorial board of any journals. Dr. Phan is a not a board member of any societies.
Data sharing statement: All technical data is available from the corresponding author at Consent was not obtained, but the presented data is anonymized and the risk of identification is low.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Duy L Phan, MD, Department of Orthopaedic Surgery, University of California, 101 The City Drive South, Irvine, CA 92868, United States.
Telephone: +1-714-4567012 Fax: +1-714-4567547
Received: January 7, 2015
Peer-review started: January 7, 2015
First decision: February 7, 2015
Revised: February 24, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: August 18, 2015
Core Tip

Core tip: Patients with preoperative anemia presenting for total joint arthroplasty (TJA) have an increased risk of requiring allogeneic blood transfusion (ABT). Current methods to increase preoperative hemoglobin is expensive, limited in efficacy, and have side effects. In this study, we found that intraoperative tranexamic acid (TXA) safely and effectively decreases blood loss and limits the rate of ABT after TJA for anemic patients. We recommend TXA for all patients without contraindications who have preoperative anemia.