Tranexamic Acid in Radical Resection and Endoprosthetic Reconstruction

Tranexamic Acid in Radical Resection and Endoprosthetic Reconstruction: A Randomized Controlled Trial

This study intends to determine if any correlation exists between administration of TXA or not to musculoskeletal oncology patients undergoing endoprosthetic reconstruction and blood loss and blood transfusion rates.

Resection of bony and soft tissue tumors with endoprosthetic reconstruction often presents a significant risk of perioperative blood loss requiring transfusion. Tranexamic acid (TXA) is an antifibrinolytic that is commonly used to reduce blood loss in orthopedic procedures, most often arthroplasty. The aim of this study is to determine in a randomized controlled fashion if there is any difference in perioperative blood loss and blood transfusion rates when TXA is used compared to when it is not used in patients undergoing radical resection of bone and soft tissue sarcomas with endoprosthetic reconstruction.

Inclusion Criteria:

• Patients undergoing wide resection of a malignant bony tumor of the lower extremity with endoprosthetic reconstruction.
• Patients undergoing a resection of soft tissue sarcoma measuring > 5cm.

Exclusion Criteria:

• Patients undergoing revision endoprosthetic reconstruction
• Patients with known coagulopathy
• Known history of DVT or embolic disease
• Benign tumors
• Patients with allergy to TXA
• Those refusing blood products
• Those concurrently on anti-coagulant therapy
• Pregnant and/or nursing women
• Vulnerable populations as defined by the KUMC IRB