Tranexamic acid reduces blood loss and transfusion in single-stage bilateral combined surgery for developmental dysplasia of the hip: A retrospective study.

Abstract

To determine whether tranexamic acid (TXA) reduces blood loss and transfusion rate in single-stage bilateral combined surgery for developmental dysplasia of the hip (DDH) in children. A retrospective study was conducted on 148 children with bilateral DDH who underwent single-stage bilateral combined surgery between March 2021 and May 2025. Patients were categorized into a TXA group (<i>n</i> = 71) and a control group (<i>n</i> = 77) based on TXA administration. The TXA group received a single intravenous bolus of TXA 15 mg/kg preoperatively, while the control group received no intervention. Complete blood count tests were obtained preoperatively and at 24 h postoperatively. Estimated blood loss (EBL), transfusion rate, operative duration, and complications were compared. The TXA group exhibited significantly lower EBL compared with the control group (117.5 ± 7.7 mL vs. 171.4 ± 11.3 mL; <i>p</i> < 0.001). The total transfusion rate was also lower in the TXA group (5.6 % vs. 16.9 %; <i>p</i> = 0.03), as well as the intraoperative transfusion rate (1.4% vs. 11.7%; <i>p</i> = 0.03). The median surgical duration was 2.3 h in both groups, with no significant difference (<i>p</i> = 0.29). One postoperative infection occurred in each group (1.4 % vs. 1.3 %; <i>p</i> = 1), and no cases of seizures or deep vein thrombosis were observed. TXA significantly reduces EBL and both total and intraoperative transfusion rates in children undergoing single-stage bilateral combined surgery for DDH, without affecting the risk of complications.