Role of tranexamic acid in reducing blood loss in bipolar hemiarthroplasty in the first 48 hours.

Objective: To find out the efficacy of Tranexamic acid in decreasing intraoperative and postoperative bloodloss in patients going through bipolar hemiarthroplasty (BHA) within the first 48 hours. Study Design: Randomized Controlled Trial. Setting: Ghurki Trust and Teaching Hospital, Lahore, Pakistan. Period: September 15, 2024, to December 15, 2024. Methods: Sixty-six patients with femoral neck fractures were randomized into two groups: Group A (TXA, 15 mg/kg intravenously) and Group B (placebo). Bloodloss was measured during and after surgery at 12, 24, and 48 hours using drain volumes. Data were analyzed using SPSS version 27, with Student's t-tests applied to compare outcomes between groups. Results: Group A demonstrated significantly lower intraoperative blood loss (534.85 ± 118.48 mL) than Group B (633.64 ± 127.94 mL, p = 0.002). Postoperative drain volumes were also lower in Group A at 12 hours (188.79 ± 71.80 mL vs. 225.76 ± 53.97 mL, p = 0.021), 24 hours (115.76 ± 43.16 mL vs. 167.58 ± 47.30 mL, p < 0.0001), and 48 hours (67.88 ± 39.19 mL vs. 102.12 ± 35.33mL, p < 0.0001). Total bloodloss over 48 hours was much lower in Group A (900.91 ± 222.74 mL) compared to Group B (1126.06 ± 216.97 mL, p < 0.0001). Subgroup analysis showed consistent benefits across gender, age, and BMI categories, particularly in females and older patients. Conclusion: Tranexamic acid significantly decreases intraoperative and postoperative bloodloss in patients goingthrough bipolar hemiarthroplasty (BHA) for the neck of femur fractures. These findings support the inclusion of TXA in surgical protocols to minimize blood loss, lower transfusion requirements, and reduce associated morbidity.