ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
This article is part of the Research TopicPerioperative Blood Transfusion Management in the Perioperative SettingView all 5 articles
Tranexamic Acid Combined with Fluid Gelatin in Perioperative Blood Loss Management of Total Hip Arthroplasty for Elderly Femoral Neck Fractures: A Single-Center Retrospective Analysis
Provisionally accepted
- 1North Sichuan Medical College, Nanchong, China
- 2Mianyang Third People's Hospital, Mianyang, China
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Abstract Objective Tranexamic acid (TXA) and Fluid Gelatin (FG) are widely used to reduce perioperative blood loss in total hip arthroplasty (THA). However, the efficacy of single-method hemostatic strategies is increasingly insufficient for meeting clinical demands. The aim of this study is to evaluate the efficacy of TXA in combination with FG for perioperative blood management. Methods This retrospective study enrolled 301 patients with unilateral femoral neck fractures who underwent minimally invasive piriformis approach total hip arthroplasty (2019–2023) and received hemostatics, divided into TXA (n=93), FG (n=102), and TXA+FG (n=106) groups. A control group (n=107) with the same inclusion/exclusion criteria was selected. Collected data included demographic characteristics, fracture classification, perioperative clinical parameters, and laboratory findings. The primary and secondary outcome measures included total blood loss (TBL), visible blood loss (VBL), hidden blood loss (HBL), postoperative hemoglobin (HGB) and hematocrit (HCT) levels, blood transfusion, and postoperative complications. Results The clinical results of 408 patients indicated that the combination significantly reduced perioperative blood loss in THA via MIS-TPA (550.68 ± 327.61 mL in the TXA+FG group, 732.50 ± 362.84 mL in the TXA group, 817.19 ± 375.46 mL in the FG group and 982.99 ± 428.81mL in the Control group; p < 0.001) without an increase in thromboembolic events or wound-related complications. Conclusion Combined intravenous TXA and intra-articular FG administration yields superior perioperative blood loss control and did not increase the rate of complications.
Keywords: Femoral neck fracture, Fluid gelatin, Hidden blood loss, Perioperative blood loss, Total hip arthroplasty, Tranexamic Acid
Received: 19 Oct 2025; Accepted: 26 Jan 2026.
Copyright: © 2026 Zhao, Fu, Li, Sun, Wang and Xiao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Cong Xiao
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