Effect of topical tranexamic acid administration on postoperative blood loss and hematologic parameters after reverse shoulder arthroplasty

Abstract

Background: This study aimed to investigate the effect of topical administration of TXA on blood loss and hematologic parameters following RSA. Methods: This retrospective study included 111 patients who underwent RSA mainly for cuff tear arthropathy and massive rotator cuff tears between November 2014 and September 2021, excluding patients with proximal humerus fractures, of whom 52 received TXA (TXA group) and 59 did not receive TXA (non-TXA group). In the TXA group, 1 g of TXA was administrated topically in the subacromial space after skin closure. Hematological parameters were assessed preoperatively and at postoperative days 3, 7, and 14. Intraoperative blood loss, surgical drain volume, calculated total blood loss, blood transfusion, and venous thromboembolic events were compared. Results: There was no significant difference in intraoperative blood loss between the groups. Calculated blood loss and total surgical drain volume were significantly lower in the TXA group than the non-TXA group (843 ± 334 mL vs 1051 ± 391 mL and 213 ± 142 mL vs 389 ± 164 mL,p < 0.01 and p < 0.01, respectively). In the non-TXA group, hemoglobin (Hb) and hematocrit (Hct) values decreased until postoperative day 7 before increasing at postoperative day 14; in the TXA group, these values decreased at postoperative day 3 and then increased up to postoperative day 14. No thromboembolic event occurred in either group. Conclusions: The present results showed that topical administration of TXA in RSA reduced blood loss without adverse events and promoted the early recovery of hematologic parameters.