Paper of the week: Tranexamic Acid Is Associated With Reduced Periprosthetic Joint Infection After Primary Total Joint Arthroplasty.

Paper of the week: Tranexamic Acid Is Associated With Reduced Periprosthetic Joint Infection After Primary Total Joint Arthroplasty. Yazdi H, Klement MR, Hammad M, Inoue D, Xu C, Goswami K, Parvizi J. J Arthroplasty. 2019 Oct 22. pii: S0883-5403(19)31006-X. doi: 10.1016/j.arth.2019.10.029.

Summary by Dr Sreeram Penna

In this retrospective study researchers analyzed the relation between utilization of intravenous tranexamic acid (TXA) in primary total joint arthroplasty and incidence of periprosthetic joint infection (PJI). Final cohort included 6340 patients. Of these patients 3683 received TXA prior to arthroplasty and 2657 did not receive it.  Both hip and knee arthroplasty patients were included in the study. The preliminary analyses showed that patients receiving TXA were younger, more likely to be female, had a lower BMI and comorbidities, and undergoing THA.  Incidence of PJI in patients receiving TXA was 1.6% and 3.4% in those who did not receive the TXA prior to surgery.

On further analysis after controlling for confounding variables, multivariate analysis showed that administration of TXA (OR 0.68) was associated with lower rate of PJI. TXA use was also shown to be more effective in nonanemic patients (OR 0.52) and patients undergoing hip arthroplasty (OR 0.50). In conclusion this study shows overall beneficial effect of TXA in reducing PJI infection following primary arthroplasty.