Guzel, IsmailUlusoy, IbrahimYilmaz, MehmetTantekin, Mehmet FiratKivrak, Aybars2026-06-192026-06-1920262090-34642090-3472https://doi.org/10.1155/aort/2709548https://hdl.handle.net/20.500.12899/5534Objective Total hip arthroplasty (THA) is a widely performed surgical intervention for managing severe hip pathologies. However, this procedure is often associated with substantial blood loss and an increased need for blood transfusion. Tranexamic acid (TXA), a synthetic antifibrinolytic agent, is frequently administered to mitigate perioperative bleeding. Despite its widespread use, the comparative efficacy and safety of intravenous (IV) and topical TXA administration remain subjects of ongoing debate in the literature. Materials and Methods This retrospective, single-center study evaluated 45 patients who underwent primary THA between 2020 and 2024. The patients were divided into three groups based on TXA administration: IV TXA (n = 15), topical TXA (n = 15), and a control group without TXA (n = 15). Outcomes assessed included perioperative blood loss, transfusion requirements, postoperative hemoglobin decrease, and thromboembolic complications. Group comparisons were further adjusted for baseline confounders using analysis of covariance and multivariable logistic regression. Statistical significance was set at p < 0.05. Results Both IV and topical TXA administration significantly reduced perioperative blood loss compared with the control group. Transfusion rates were numerically lower in the TXA groups, although these differences did not reach statistical significance after adjustment. Mean blood loss was recorded as 820 mL in the IV TXA group, 840 mL in the topical TXA group, and 1100 mL in the control group. No significant difference was found between the IV and topical TXA groups, while both were superior to the control group in terms of hemoglobin decline. Thromboembolic complications and surgical site infection rates were comparable across all groups. Discussion The findings of this study demonstrate that both IV and topical TXA administration provide effective and safe control of perioperative bleeding in THA. The low incidence of thromboembolic events supports the safe use of TXA in clinical practice. Selection of the TXA administration route can be tailored based on patient-specific clinical conditions and the surgeon's preference. Conclusion In conclusion, the appropriate use of TXA during THA effectively reduces the need for blood transfusion and contributes to improved surgical outcomes. These results highlight the value of TXA as a reliable hemostatic agent in modern orthopedic surgery.eninfo:eu-repo/semantics/openAccessBlood LossTotal Hip ArthroplastyTranexamic AcidTransfusionArticle10.1155/aort/2709548202612-s2.0-105031088293Q2WOS:001699032000001Q30000-0003-2348-83390000-0002-1366-91630000-0003-2740-41390000-0003-0657-2213