Osteoarthritis is the most common chronic disease of the elderly. In the last phase of the disease the only therapeutic solution is surgery of insertion of total endoprosthesis, which commonly results in heavy acute bleeding and consequently anemia. To reduce such bleeding, tranexamic acid (TA) is occasionally used at the Department of Orthopedics, General Hospital of Murska Sobota. By comparing medical records of the patients who were and who were not treated with TA, we verified the effectiveness and safety of TA at operations of insertion of total knee and hip endoprosthesis. The investigated groups included 68 patients treated with TA and 68 patients who did not receive TA. 1000 mg of the TA was administered i.v. prior to surgery and 1000 mg were administered i.v. about 6 hours after surgery. Based on treatment with TA patient groups were statistically compared. Total blood loss was lower in the TA group (p = 0.034) when compared with group who did not receive the TA. Thus, we confirmed the effectiveness of TA in reducing perioperative bleeding at the operations of insertion of total endoprothesis. The number of adverse events (thromboembolic complications, worsening of renal function, number of secretions and punctures) and duration of hospitalization were not statistically significantly different between the two groups. Comparison of the average cost of treatment during hospitalization showed a statistically significant difference (p = 0.001). Research confirmed the effectiveness of TA in reducing perioperative bleeding in total joint arthroplasty, whereby the probability of adverse events did not increase and the cost of treatment during hospitalization was reduced. Based on published results and our experiences, we recommend the implementation of treatment with TA into regular clinical practice.
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