Blood-saving Effect of Combined Intravenous Tranexamic Acid With Topical Floseal® Application Total Hip Arthroplasty

Last updated: January 16, 2020
Sponsor: Chang Gung Memorial Hospital
Overall Status: Active - Recruiting

Phase

4

Condition

N/A

Treatment

N/A

Clinical Study ID

NCT03623789
201701718A3
  • Ages 18-90
  • All Genders
  • Accepts Healthy Volunteers

Study Summary

Total hip arthroplasty (THA) is an excellent surgical procedure for patients with end-stage hip diseases. However, THA is associated with considerable blood loss and increasing needs for allogenic blood transfusion. Tranexamic acid (TXA) was reportedly effective reducing total blood loss (TBL) after standard THA. However, a TBL of one L is still high for elderly patients.

Floseal (Baxter, Deerfield, Illinois), a thrombin-based hemostatic agent, have been widely used in surgical procedure. However, there is no study investigating the effect of Floseal in THA procedures.This study anticipated that combination with the two different mechanism of topical hemostatic agent, Floseal, and intravenous TXA can bring a synergistic blood saving effect in THA patients.

Purpose:

Our purpose of this study therefore is to conduct a prospective randomized controlled trial to investigate the blood-conservation effect of combination of intravenous TXA and topical Floseal in a primary THA procedure.

Material and Methods:

The patients who are enrolled in this study will be assigned into three groups. The first group will be treated by combination of 1 g of TXA pre-operatively and two boluses TXA post-operatively intravenously and Floseal topical application, the second group by 1 g of TXA pre-operatively and two boluses TXA postoperatively intravenously without Floseal use, and the third group was control group which will be treated without TXA and Floseal. This study will observe whether there is difference in the blood-conservation effect by total blood loss calculation, hemoglobin loss and transfusion requirement between these three groups.

This study anticipate that combined use of intravenous TXA and Floseal in THA procedure is more effective in decreasing blood loss and blood transfusion than intravenous TXA application alone, and this formula do not increase the risk of thromboembolic disease.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Patients with osteoarthritis of the hip secondary to degeneration, inflammatoryarthritis, gouty arthritis, acetabular dysplasia or osteonecrosis of the femoral head,and undergoing primary unilateral minimally invasive THA

  2. Age > 18 years and < 90 years

  3. Failure of medical treatment or rehabilitation.

  4. Hemoglobin > 11g/dl,

  5. No use of non-steroid anti-inflammatory agent one week before operation

Exclusion

Exclusion Criteria:

  1. Preoperative Hemoglobin ≦11 g/dl

  2. History of infection or intraarticular fracture of the affective hip

  3. Renal function deficiency (GFR <30 ml/min/1.73m2)

  4. Elevated liver enzyme (aspartate transaminase (AST)/ alanine transaminase(ALT) levelare more than twice normal range) , history of liver cirrhosis, impaired liverfunction(elevated total bilirubin level) and coagulopathy (including long-term useanticoagulant)

  5. History of deep vein thrombosis, ischemic heart disease or stroke

  6. Contraindications of tranexamic acid, floseal, or rivaroxaban

  7. Allergy to tranexamic acid, floseal, rivaroxaban, or the excipients

  8. History of heparin-induced thrombocytopenia (HIT)

  9. Coagulopathy or bleeding tendency caused by organ dysfunction, such as cirrhosis, bonemarrow suppression etc.

  10. Patient who have active bleeding disorder, such as intracranial hemorrhage, uppergastrointestinal bleeding, hematuria.

  11. Patients with known allergies to materials of bovine origin.

Study Design

Total Participants: 90
Study Start date:
August 15, 2018
Estimated Completion Date:
July 31, 2020

Connect with a study center

  • Kaohsiung Chang Gung Memorial Hospital

    Kaohsiung,
    Taiwan

    Active - Recruiting

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