Topical, intravenous tranexamic acid and their combined use are equivalent in reducing blood loss after primary total hip arthroplasty

OBJECTIVE To determine the equivalence of tranexamic acid (TXA) administration topically, intravenously or the combination of both routes are equivalent in reducing blood loss after primary total hip arthroplasty. MATERIAL AND METHODS In this prospective study, we divided 285 total hip arthroplasty into 4 groups. Group A received 2,5g of intraarticular topical TXA, Group B did not receive TXA, Group C received 1g intravenous TXA and group D a combination of topical and intravenous TXA. The main outcome was blood loss according to Nadler's formula and total hemoglobin. RESULTS Blood loss was significantly greater in Group B (Group A. 797.13ml; Group B: 1,308.24; Group C: 986.30 and Group D: 859.09ml; P