The effects of press-fit technique combined with tranexamic acid on duration of surgery and intraoperative blood loss in primary total hip arthroplasty

Background: Prolonged operative time and blood loss may affect the success rate in total hip arthroplasty (THA). The aim of the current study was to evaluate the effects of the press-fit (PF) technique without screws combined with tranexamic acid (TXA) on operative time and intraoperative blood loss in THA. Methods: We retrospectively evaluated 114 hips treated with THA between March 2017 and January 2021 in this study. The patients were divided into three groups, including PF-TXA group, only PF group, and screw group. PF-TXA group received intravenous (IV) 1 g TXA 15 minutes before surgical incision, followed by a peri-articular 1 g/50 ml TXA. Only the PF group and screw group did not receive TXA. The primary outcome measures were operative time and intraoperative blood loss. Secondary outcomes included postoperative blood loss, hemoglobin and hematocrit levels, allogeneic blood transfusions, length of hospital stay, the Harris Hip Score (HHS), and thromboembolic complications. Results: Operative time was lower in the PF-TXA group than that in the only PF and the screw group (p=0.0001). Intraoperative blood loss was significantly different in the PF-TXA group compared with the only PF and the screw group (423 ml, 516 ml, and 534 ml; respectively). The patients who received the PF technique combined with TXA had significantly less hospital stay length than the only PF group and the screw group (p=0.021). Conclusion: The findings obtained in this study suggest that although only the PF technique can provide a shorter operative time compared to using screws, less blood loss may not be obtained using this technique in THA. PF technique combined with TXA significantly decreased operation time and intraoperative blood loss as well as the length of hospital stay following primary THA.