Efficacy of postoperative tranexamic acid administration in patients undergoing proximal femoral tumor endoprosthesis reconstruction

Patients undergoing wide surgical resection and endoprosthesis of the proximal femur experience complications such as wound complications due to postoperative bleeding, complications related to blood replacement, infections related to surgical drains, and mobilization problems, increasing hospital length of stay and costs. Our aim is to evaluate the reduction in these problems in patients with postoperative tranexamic acid use. All patients received a bolus of intravenous tranexamic acid at a dose of 15 cc/kg preoperatively, and local tranexamic acid was used during closure. This was applied to Group 1, while Group 2 received additional intravenous tranexamic acid at a dose of 1 g/day for 3 days postoperatively. Patients' risk of postoperative thromboembolic events, blood transfusion rates, postoperative wound healing problems, infection rates, mobilization times, physiotherapy initiation and hospital stay, and surgical drain removal times were compared retrospectively. Patients belonging to Group 2 (who received postoperative tranexamic acid) had earlier mobilization, initiation of physiotherapy, and shorter hospital stay (P < 0.001). They also had shorter surgical drain removal times and less blood transfusion volume (P < 0.001 for both). There were no significant differences in hematoma-related infection, age, gender, and primary/metastasis rates between the groups. We believe that postoperative tranexamic acid use will reduce complications related to blood replacement, reduce hospital-acquired infections and costs through earlier surgical drain removal and shorter hospital stays, and provide better protection against thromboembolic events and allow the patient to regain vital functions more quickly through earlier mobilization and initiation of physiotherapy.