Risk Factors for Transfusion and Use of Tranexemic Acid in Patients with Rheumatoid Arthritis Undergoing Total Hip Arthroplasty and Total Knee Arthroplasty
Utilization of total hip and total knee replacement remains high for patients with rheumatoid arthritis (RA), and most patients have moderate to high disease activity at the time of surgery. Risk of infection and a blood transfusion are higher in these individuals compared to patients with osteoarthritis, and a transfusion at the time of surgery increases the risk of perioperative infection.
The use of tranexamic acid has become widespread, as it has been associated with a lower rate of blood transfusions in osteoarthritis patients having joint replacement surgery. Investigators set out to determine if the use of TXA could also reduce transfusions for patients with rheumatoid arthritis having a hip or knee replacement. The researchers found that TXA was not associated with a lower transfusion rate in patients with RA. They concluded that pre-surgical optimization should include assessment and treatment of anemia in patients with RA who are scheduled for a total joint replacement.
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the tenth consecutive year), No. 3 in rheumatology by U.S. News & World Report (2019-2020), and named a leader in pediatric orthopedics by U.S. News & World Report “Best Children’s Hospitals” list (2019-2020). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In addition, HSS will be opening a new facility in Florida in early 2020. In 2018, HSS provided care to 139,000 patients and performed more than 32,000 surgical procedures, and people from all 50 U.S. states and 80 countries travelled to receive care at HSS. There were more than 37,000 pediatric visits to the HSS Lerner Children’s Pavilion for treatment by a team of interdisciplinary experts. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is the world’s leading provider of education on musculoskeletal health, with its online learning platform offering more than 600 courses to more than 21,000 medical professional members worldwide. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.