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.
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